STUDY OF PLACENTAS OF HYPERTENSIVE MOTHERS ASSISTED IN TWO PUBLIC MATERNITIES OF RECIFE-PE
Karinne Gomes Mendonça1*, Evandro Valentim da Silva2, Fálba Bernadete Ramos dos Anjos3
1UFPE, 2Pathology Laboratory of Hospital das ClínicasHC/UFPE, 3Professor / Researcher at the Department of Histology and Embryology – UFPE
Objective: Perform the histomorphometric study of the following regions: areas of perivillous fibrin deposition; thickness of the endothelial layer of the vessels; analysis of Tenney-Parker changes. Analyze the Placental Index (IP).
Results: It was seen that the weight of the placentas increased according to the weight of the newborn, however, when the variable PI was analyzed as being decisive for the development of a risk-free pregnancy, it was found that this parameter was not significant between the groups studied. (p <0.05). It was found that there is a significant difference in relation to the areas of fibrin deposition (P <0.05) between the groups and that it possibly converges with the data found in the literature in which it could be established that in the GrH there is a different relationship in this pattern. The findings of the thickness of the middle layer were significant in the GrH when compared to the GrN (p <0.05), when this parameter is compared between the Hypertensive Disorders of Pregnancy (HDP) groups, microscopically the PE cases showed prominent changes. I n the present study, Tenney-Parker changes were prominent and discreet in 75% of the GrH placentas versus 20% in the GrN. However, there are contradictions in the literature regarding the consideration of this finding seen only in Hematoxylin-Eosin staining.
Conclusion: Given the above, the presence of syncytial knots, the difference between vessel thickness and areas of fibrin deposition are possibly involved in the pathogenesis of Hypertensive Syndromes, regardless of age and established classifications. In order to evaluate syncytial knots, further studies are needed in this population.
Keywords: placenta; hypertension; endothelium; fibrosis; syncytial knots
How to cite this article:
Karinne Gomes Mendonça, Evandro Valentim da Silva, Fálba Bernadete Ramos dos Anjos.STUDY OF PLACENTAS OF HYPERTENSIVE MOTHERS ASSISTED IN TWO PUBLIC MATERNITIES OF RECIFE-PE. International Research Journal of Obstetrics and Gynecology, 2021, 4:39. DOI: 10.28933/irjog-2021-06-2805
1. ALMEIDA, G. B. S.; SOUZA, M. C. M. The knowledge of pregnant women about hypertension in pregnancy. Rev. APS, Juiz de Fora-MG, v. 19, n. 3, p. 396-402, 2016.
2. AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics & Gynecology, Washington-DC, v. 122, n. 5, p. 1122-1131, 2013.
3. PATHOLOGICAL ANATOMY, UFMG. Villitis and placental infarctions. Available at: <http://anatpat.unicamp.br/lamgin28.html>. Accessed: 05 Jun. 2019.
4. ARTICO, L. G. et al. Histopathological changes in human placentas related to hypertensive syndromes. Brazilian Journal of Gynecology and Obstetrics, Caxias do Sul-RGS, v. 31, n.1, p. 10-16, 2009.
5. BRAZIL. Ministry of Health. Health Care Secretariat. Department of Strategic Programmatic Actions. High-risk pregnancy: technical manual. 5. ed. – Brasília: Publisher of the Ministry of Health, 2012. 302 p.
6. MINISTRY OF HEALTH [Internet]. Executive Secretary. Datasus. Mortality indicator for pregnancy-puerperal hypertensive disorders. Available at: <http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sim/cnv/obt10uf.def>. Accessed on: 19 Apr. 2019.
7. DIAS, R .; RUDGE, M. V. C .; TRINDADE, J. C. S. Experimental Arterial Hypertension and Pregnancy in Rats: Effects on Placenta Weight and Placental Index. Brazilian Journal of Gynecology and Obstetrics, Botucatu – SP, v. 23, n. 2, p. 87-91, 2001.
8. DUCRAY, J.F.; THAJASVARIE N.; MOODLEY, J. Pilot study of comparative placental morphometry in pre-eclamptic and normotensive pregnancies suggests possible maladaptations of the fetal component of the placenta. European Journal of Obstetrics & Gynecology and Reproductive Biology, v. 156, n. 1, p. 29-34, 2011.
9. FOGARTY N. M.; FERGUSON-SMITH, A.C.; BURTON, G. J. Syncytial knots (Tenney-Parker changes) in the human placenta: evidence of loss of transcriptional activity and oxidative damage. The American Journal of Pathology, Cambridge-UK, v. 183, n. 1, p. 144-152, 2013.
10. GÓMEZ, R. P; OTTONE, N. E; BIANCH, H. Morphological Features of the Human Placenta and its Free Chorionic Villi in Normal Pregnancies and those with Diabetes and High Blood Pressure. Literature Review. International Journal of Morphology, Temuco-Chile, v. 36, n. 4, p. 1183-1192, 2018.
11. HERNÁNDEZ, M. O. Stereological morpho studio in placentas of hypertensive pregnant women with simple embarazo. Multimed. Medical Journal. Granma. Granma, Cuba, 2018; 22 (3).
12. LOWDERMILK, D. L.; PERRY, S. E.; BOBAK, I. M. Maternal Nursing Care. 5th ed. Porto Alegre: Artmed Editora, 2002, p. 297-313.
13. MASNEI, L. T. A. Nursing care provided to patients with pre-eclampsia and eclampsia in an emergency care service: intervention proposal. Journal of the USP School of Nursing, v. 50, n. 2, p. 324-334, 2014.
14. OLIVEIRA, L. F. Study of placental changes in pregnant women with antiphospholipid syndrome: anatomical-clinical correlations. Thesis (Doctorate in Sciences). University of Sao Paulo. São Paulo, 2004.
15. National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. American Journal of Obstetrics and Gynecology, v. 183, n. 1, 2000.
16. SILVA, R. V. G. Specific hypertensive disease of pregnancy – intervention project to work with pregnant women in the territory of the family health strategy in the municipality of Pedra do Anta, Minas Gerais. Completion of course work. Federal University of Minas Gerais. Faculty of Medicine. Collective Health Education Center. Conselheiro Lafaiete, 31f. 2015.
17. SILVA, S. D. et al. When to introduce pharmacological treatment in Pre-Eclampsia. Brazilian journal of health and biomedical sciences, Rio de Janeiro-RJ, v. 14, n. 2, p. 87, 93, 2015.
18. SOUZA, D. A. et al. Increase in perivilositary fibrinoid material in placental pregnancies with pre-eclampsia. Brazilian Journal of Pathology and Laboratory Medicine, Rio de Janeiro, Vol. 47 n. 1, 2011.
19. ZANATELLI, C. Hypertensive syndromes in pregnancy: strategies to reduce maternal mortality. Revista Integrada Saúde, v. 9, n. 17, p. 73-81, 2016. Available at: <http://local.cnecsan.edu.br/revista/index.php/saude/index>. Accessed on April 12, 2019.