Journal of Pathology and Translational Medicine

Yeon Mee Kim

2 Articles

Chronic Placental Inflammation in Twin Pregnancies: Heejin Bang, Go Eun Bae, Ha Young Park, Yeon Mee Kim, Suk-Joo Choi, Soo-young Oh, Cheong-Rae Roh, Jung-Sun Kim; J Pathol Transl Med. 2015;49(6):489-496. Published online October 13, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.09

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Background
Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection. The aim of this study is to investigate its frequency in twin pregnancies compared to singleton pregnancies. Methods: Three hundred twin placentas and 1,270 singleton placentas were consecutively collected at a tertiary medical center in Seoul, Republic of Korea from 2009 to 2012. Hematoxylin and eosin sections of tissue samples (full-thickness placental disc and chorioamniotic membranes) were reviewed. Results: Non-basal VUE was more frequent in twin placentas than in singleton placentas (6.0% vs 3.2%, p < .05). In preterm birth, CCA was found less frequently in twin placentas than in singleton placentas (9.6% vs 14.8%, p < .05), reaching its peak at an earlier gestational age in twin placentas (29–32 weeks) than in singleton placentas (33–36 weeks). CCA was more frequent in twin pregnancies with babies of a different sex than with those with the same sex (13.8% vs 6.9%, p = .052). Separate dichorionic diamniotic twin placentas were affected by chronic deciduitis more frequently than singleton placentas (16.9% vs 9.7%, p < .05). Conclusions: The higher frequency of non-basal VUE in twin placentas and of CCA in twin placentas with different fetal sex supports the hypothesis that the underlying pathophysiological mechanism is maternal anti-fetal rejection related to increased fetal antigens in twin pregnancies. The peak of CCA at an earlier gestational age in twin placentas than in singleton placentas suggests that CCA is influenced by placental maturation.

Citations

Citations to this article as recorded by

Villitis of unknown etiology, chronic deciduitis, chronic chorioamnionitis and chronic histiocytic intervillositis in monozygotic and dizygotic twin pregnancies. A retrospective analysis of 16 cases
Henning Feist, Ulrich Lehmann, Simin Bajwa, Corinna Brüschke, Nora Schaumann
Placenta.2023; 133: 32. CrossRef
Discordant Eosinophilic/T-Cell Chorionic Vasculitis in a Dichorionic Diamniotic Placenta
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International Journal of Molecular Sciences.2023; 24(11): 9207. CrossRef
Histopathologic evaluation of dichorionic twin placentas in unassisted and in vitro fertilized pregnancies affected by preeclampsia
Evelina Manvelyan, Karmaine A. Millington, Baruch S. Abittan, Matthew J. Blitz, Brittany Kwait, Weiwei Shan, Randi H. Goldman
The Journal of Maternal-Fetal & Neonatal Medicine.2022; 35(26): 10262. CrossRef
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Disorders of placental villous maturation in fetal death
Sunil Jaiman, Roberto Romero, Percy Pacora, Eunjung Jung, Gaurav Bhatti, Lami Yeo, Yeon Mee Kim, Bomi Kim, Chong Jai Kim, Jung-Sun Kim, Faisal Qureshi, Suzanne M. Jacques, Offer Erez, Nardhy Gomez-Lopez, Chaur-Dong Hsu
Journal of Perinatal Medicine.2020;[Epub] CrossRef
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Kyung Joon Oh, Joon-Seok Hong, Roberto Romero, Bo Hyun Yoon
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Differential immunophenotype of macrophages in acute and chronic chorioamnionitis
Go-Eun Bae, Joon-Seok Hong, Jung-Sun Kim, Ha Young Park, Ja Yun Jang, Yi Seul Kim, Suk-Joo Choi, Soo-young Oh, Cheong-Rae Roh
Journal of Perinatal Medicine.2017; 45(4): 483. CrossRef
Fetal death: an extreme manifestation of maternal anti-fetal rejection
Kia Lannaman, Roberto Romero, Tinnakorn Chaiworapongsa, Yeon Mee Kim, Steven J. Korzeniewski, Eli Maymon, Nardhy Gomez-Lopez, Bogdan Panaitescu, Sonia S. Hassan, Lami Yeo, Bo Hyun Yoon, Chong Jai Kim, Offer Erez
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Acute Atherosis of the Uterine Spiral Arteries: Clinicopathologic Implications: Joo-Yeon Kim, Yeon Mee Kim; J Pathol Transl Med. 2015;49(6):462-471. Published online November 4, 2015; DOI: https://doi.org/10.4132/jptm.2015.10.23

15,182 View
202 Download
26 Web of Science
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Abstract PDF

Acute atherosis is unique vascular changes of the placenta associated with poor placentation. It is characterized by subendothelial lipid-filled foam cells, fibrinoid necrosis of the arterial wall, perivascular lymphocytic infiltration, and it is histologically similar to early-stage atherosclerosis. Acute atherosis is rare in normal pregnancies, but is frequently observed in non- transformed spiral arteries in abnormal pregnancies, such as preeclampsia, small for gestational age (SGA), fetal death, spontaneous preterm labor and preterm premature rupture of membranes. In preeclampsia, spiral arteries fail to develop physiologic transformation and retain thick walls and a narrow lumen. Failure of physiologic transformation of spiral arteries is believed to be the main cause of uteroplacental ischemia, which can lead to the production of anti-angiogenic factors and induce endothelial dysfunction and eventually predispose the pregnancy to preeclampsia. Acute atherosis is more frequently observed in the spiral arteries of the decidua of the placenta (parietalis or basalis) than in the decidual or myometrial segments of the placental bed. The presence and deeper location of acute atherosis is associated with poorer pregnancy outcomes, more severe disease, earlier onset of preeclampsia, and a greater frequency of SGA neonates in patients with preeclampsia. Moreover, the idea that the presence of acute atherosis in the placenta may increase the risk of future cardiovascular disease in women with a history of preeclampsia is of growing concern. Therefore, placental examination is crucial for retrospective investigation of pregnancy complications and outcomes, and accurate placental pathology based on universal diagnostic criteria in patients with abnormal pregnancies is essential for clinicopathologic correlation.

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