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Am J Perinatol 2020; 37(12): 1217-1222
DOI: 10.1055/s-0039-1692716
Original Article

Placental Findings in Postpartum Preeclampsia: A Comparative Retrospective Study

Agnès Ditisheim 
1   Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, Texas
2   Departments of Internal Medicine Specialties and Gynecology and Obstetrics, University of Geneva, Switzerland
,
Baha Sibai
1   Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, Texas
,
Nina Tatevian
3   Department of Pathology and Laboratory Medicine, The University of Texas Medical School at Houston, Houston, Texas
› Author Affiliations Funding A.D. received a grant from the Swiss National Science Foundation.
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Abstract

Objective Preeclampsia is a multifactorial placental disease that can occur after delivery. The pathophysiology of postpartum preeclampsia remains unknown. The objective was to describe placental findings in postpartum preeclampsia.

Study Design This is a case–control study, comparing the placental histologic findings in four groups of 30 patients with postpartum preeclampsia, early-onset preeclampsia, late-onset preeclampsia, and normotensive controls.

Results Placentas of postpartum preeclampsia had a mean placental weight not different from that of late-onset preeclampsia at a similar gestational age (479.0 ± 152.7 vs. 521.3 ± 144.1 g, p = 0.07); they showed a higher rate of acute deciduitis of 42.4% than early preeclampsia (5.7%, p < 0.01) or in controls (3.2%, p < 0.01); 18.2% had decidual arteriolopathy, with no significant difference with other groups. These placentas had fewer villous infarcts as compared with early preeclampsia (9.1 vs. 62.9%, p < 0.01) and less accelerated maturation of villi (24.2 vs. 74.3%, p < 0.01).

Conclusion There were no significant differences for decidual arteriolopathy and villous infarcts among postpartum preeclampsia, late-onset preeclampsia, and the controls. This suggests that postpartum preeclampsia is more of a maternal disease in which the placenta may act as a priming effect in predisposed mothers and becomes clinically apparent after delivery.

Keywords

postpartum period - preeclampsia - pregnancy - hypertension - placental findings - placental disease

Note

This work has been presented to the fall meeting of the Society for Pediatric Pathology 2016, Honolulu, Hawaii.


Supplementary Material



Publication History

Received: 19 December 2018

Accepted: 14 May 2019

Article published online:
02 July 2019

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