• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
10.11606/D.5.2004.tde-12082005-163445
Document
Author
Full name
Catia Cristine Chuba da Silva
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2004
Supervisor
Committee
Miyadahira, Seizo (President)
Rezende, Waldemir Washington
Schultz, Regina
Title in Portuguese
"Estudo histopatológico comparativo de placentas oriundas de gestações com diástole zero ou reversa à dopplervelocimetria das artérias umbilicais"
Keywords in Portuguese
ARTÉRIAS UMBILICAIS/ultrasonografia
DOENÇAS PLACENTÁRIAS/diagnóstico
ESTUDOS RETROSPECTIVOS
HISTOLOGIA COMPARADA/estatística & dados numéricos
INSUFICIÊNCIA PLACENTÁRIA/ultrasonografia
MICROSCOPIA/estatística & dados numéricos
ULTRA-SONOGRAFIA DOPPLER EM CORES/métodos
Abstract in Portuguese
Com o intuito de estudar a histopatologia da placenta na insuficiência grave desse órgão, foram selecionados preparados histológicos de 140 placentas oriundas de gestações com diástole zero (DZ) ou diástole reversa (DR) à dopplervelocimetria das artérias umbilicais, acompanhadas no Setor de Avaliação da Vitalidade Fetal da Clínica Obstétrica do HCFMUSP, de 1992 a 2000. Para tal fim, foram revisadas as lâminas histológicas arquivadas na Divisão de Anatomia Patológica do HCFMUSP. Em etapa inicial, foi efetuado um estudo descritivo das lesões encontradas e relatadas, em freqüência, no grupo de DZ e no grupo de DR. Na segunda etapa, os casos foram discriminados em cinco grupos, segundo uma classificação etiopatogênica, para cotejá-los aos aspectos clínicos como: idade gestacional (IG) no nascimento, ocorrência de restrição do crescimento fetal (RCF), peso do recém-nascido (RN) e peso da placenta. Em complemento, os grupos constituídos foram relacionados à gravidade da insuficiência placentária, confrontando-se os grupos de DZ e DR.A análise histopatológica demonstrou que o infarto viloso foi o tipo de lesão isolada mais freqüente, e que o Grupo 2 (Lesões envolvendo patologia vascular uteroplacentária e dano em vilosidades secundárias), foi o grupo etiopatogênico mais freqüente na população geral. Não houve correlação dos achados histológicos com a IG no nascimento, RCF e peso do RN. Nas placentas gravemente insuficientes (DR), a proporção de infartos vilosos, trombose intervilosa e as lesões pertencentes ao grupo 3 (lesões envolvendo coagulação) foi significativamente maior do que nas de gravidade menor (DZ). O conhecimento mais profundo dos mecanismos fisiopatológicos envolvidos na insuficiência placentária, cujos reflexos se manifestam nos achados histopatológicos, são essenciais para a busca de novas alternativas para promover melhorias na condução desses casos, principalmente no que concerne à instituição de terapêutica específica e adequada. No presente trabalho ficou evidente a importância da presença de lesões envolvendo coagulação como marcadores de gravidade na insuficiência placentária.
Title in English
Comparative histopathological study of placentas from pregnancies with absent or reversed end-diastolic velocity flow in the dopplervelocimetry of the umbilical arteries
Keywords in English
HISTOLOGY COMPARATIVE/statistics & numerical data
MICROSCOPY/statistics & numerical data
PLACENTA DISEASES/diagnosis
PLACENTAL INSUFFICIENCY/ultrasonography
RETROSPECTIVE STUDIES
ULTRASONOGRAPHY DOPPLER COLOR/methods
UMBILICAL ARTERIES/ultrasonography
Abstract in English
Histological features of 140 placentas from pregnancies with absent or reversed end-diastolic velocity flow were selected for the study of placental histopathology in cases of severe failure of the organ. All the pregnancies were followed-up in the Fetal Surveillance Unit of the Department of Obstetrics - HC FMUSP, from 1992 to 2000. For this purpose, the review of the histological features archived in the Department of Pathology - HCFMUSP was performed. The first step of the process involved a descriptive study of the findings reported, in frequency, in the AEDVF and REDVF groups. In the following step, cases were separated into five groups, according to an etiopathogenic classification, for the purpose of comparing clinical aspects such as: gestational age at birth, occurrence of fetal growth restriction, newborn weight and placental weight.In addition, the correlation between those groups and the severity of placental insufficiency/failure was analyzed, and both groups of absent and reversed end-diastolic velocity flow were compared. The histopathological analysis showed that villous infarcts were the most frequent lesion found in the histological features, and Group 2 (lesions involving uteroplacental vascular pathology and secondary villous damage) was the most frequent etiopathogenic group in general population. No correlation was found between the histological findings and gestational age, fetal growth restriction and weight of the newborn. In those placentas in which severe failure was detected, the proportional rate of villous infarcts, intervillous thrombosis and lesions found in Group 3 (lesions involving coagulation) was significantly higher than in those with less severe failure (absent end-diastolic velocity flow). Further studies of the pathophysiological mechanisms of placental insufficiency which result in the histopathological findings are essential for improving the follow-up in those cases, principally when specific and appropriate therapy is considered. In this study, the importance of the presence of lesions presenting coagulation as markers of severity in the placental insufficiency is evident.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2005-08-15
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
Centro de Informática de São Carlos
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2022. All rights reserved.