Pathologic evaluation of normal and perfused term placental tissue
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Pathologic evaluation of normal and perfused term placental tissue. / Maroun, Lisa Leth; Mathiesen, Line; Hedegaard, Morten; Knudsen, Lisbeth E.; Larsen, Lise Grupe.
In: Pediatric and Developmental Pathology, Vol. 17, No. 5, 09.2014, p. 330-8.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Pathologic evaluation of normal and perfused term placental tissue
AU - Maroun, Lisa Leth
AU - Mathiesen, Line
AU - Hedegaard, Morten
AU - Knudsen, Lisbeth E.
AU - Larsen, Lise Grupe
PY - 2014/9
Y1 - 2014/9
N2 - This study reports for the 1st time the incidence and interobserver variation of morphologic findings in a series of 34 term placentas from pregnancies with normal outcome used for perfusion studies. Histologic evaluation of placental tissue is challenging, especially when it comes to defining "normal tissue" versus "pathologic lesions." A scoring system for registration of abnormal morphologic findings was developed. Light microscopic examination was performed independently by 2 pathologists, and interobserver variation was analyzed. Findings in normal and perfused tissue were compared and selected findings were tested against success parameters from the perfusions. Finally, the criteria for frequent lesions with fair to poor interobserver variation in the nonperfused tissue were revised and reanalyzed. In the perfused tissue, the perfusion artefact "trophoblastic vacuolization," which is believed to represent dilated transtrophoblastic channels, was reproducible and significantly correlated to the perfusion marker "fetal leakage." In longer perfusions, microscopy of the perfused cotyledon revealed bacteria in the fetal vessels. This finding led to an adjustment in the perfusion protocol with addition of antibiotics to the medium. In the "normal" tissue, certain lesions were very frequent and showed only fair or poor interobserver agreement. Revised minimum criteria for these lesions were defined and found reproducible. This study has emphasized the value of pathologic examination as a supplement in placental perfusion models. Examination of the perfused cotyledon for trophoblastic vacuolization is recommended as an additional quality marker in perfusion models. The study also underlines the need for exact definitions of abnormality in frequent placental lesions.
AB - This study reports for the 1st time the incidence and interobserver variation of morphologic findings in a series of 34 term placentas from pregnancies with normal outcome used for perfusion studies. Histologic evaluation of placental tissue is challenging, especially when it comes to defining "normal tissue" versus "pathologic lesions." A scoring system for registration of abnormal morphologic findings was developed. Light microscopic examination was performed independently by 2 pathologists, and interobserver variation was analyzed. Findings in normal and perfused tissue were compared and selected findings were tested against success parameters from the perfusions. Finally, the criteria for frequent lesions with fair to poor interobserver variation in the nonperfused tissue were revised and reanalyzed. In the perfused tissue, the perfusion artefact "trophoblastic vacuolization," which is believed to represent dilated transtrophoblastic channels, was reproducible and significantly correlated to the perfusion marker "fetal leakage." In longer perfusions, microscopy of the perfused cotyledon revealed bacteria in the fetal vessels. This finding led to an adjustment in the perfusion protocol with addition of antibiotics to the medium. In the "normal" tissue, certain lesions were very frequent and showed only fair or poor interobserver agreement. Revised minimum criteria for these lesions were defined and found reproducible. This study has emphasized the value of pathologic examination as a supplement in placental perfusion models. Examination of the perfused cotyledon for trophoblastic vacuolization is recommended as an additional quality marker in perfusion models. The study also underlines the need for exact definitions of abnormality in frequent placental lesions.
KW - Female
KW - Fetus
KW - Humans
KW - Perfusion
KW - Placenta
KW - Placenta Diseases
KW - Pregnancy
KW - Trophoblasts
U2 - 10.2350/12-08-1243-OA.1
DO - 10.2350/12-08-1243-OA.1
M3 - Journal article
C2 - 24945897
VL - 17
SP - 330
EP - 338
JO - Pediatric and Developmental Pathology
JF - Pediatric and Developmental Pathology
SN - 1093-5266
IS - 5
ER -
ID: 137757606