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Original Article

The frequency of acute atherosis in normal pregnancy and preterm labor, preeclampsia, small-for-gestational age, fetal death and midtrimester spontaneous abortion^*

Yeon Mee KimDepartment of Pathology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea, Correspondence[email protected]

Piya ChaemsaithongPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA,

Roberto RomeroPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA, ;Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA, Correspondence[email protected]

Majid ShamanPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA,

Chong Jai KimPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea,

Jung-Sun KimPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Pathology, Samsung Medical Center, University of Sungkyunkwan School of Medicine, Seoul, Korea,

Faisal QureshiPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Pathology, Harper University Hospital, Detroit, MI, USA, and ;Department of Pathology, Wayne State University, Detroit, MI, USA

Suzanne M. JacquesPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Pathology, Harper University Hospital, Detroit, MI, USA, and ;Department of Pathology, Wayne State University, Detroit, MI, USA

Ahmed I. AhmedPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA,

Tinnakorn ChaiworapongsaPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA,

Sonia S. HassanPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA,

Lami YeoPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA,

Steven J. KorzeniewskiPerinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI, USA, ;Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA, ;Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA,

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Figures & data

Figure 1. Acute atherosis in the decidual segment of spiral arteries (Hematoxylin and Eosin, ×400). (A) Fibrinoid necrosis (blue arrow) and few chronic inflammatory cells within the vessel wall but no macrophages; (B) mainly lipid-laden macrophages (black arrows) with minor fibrinoid necrosis (blue arrow) in the vessel wall and (C) fibrinoid necrosis (blue arrow) with lipid-laden macrophages (black arrow) as well as chronic inflammatory cells (white arrows) in the vessel wall and perivascular areas. * Lumen of spiral artery.

Table 1. Clinical diagnosis of patients included in the study.

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Figure 2. Frequency of acute atherosis according to pregnancy outcomes. Each patient with pregnancy complications was classified according to a mutually exclusive schema. Abortion: midtrimester abortion, SGA: small-for-gestational age, sPTL: spontaneous preterm labor, PPROM: preterm prelabor rupture of membranes. SGA group included patients with SGA neonates without fetal death, pregnancy associated hypertension and spontaneous preterm birth. Comparison between each pregnancy complication and term delivery: p < 0.001 for all.

Table 2. Clinical characteristics and pregnancy outcome of patients with preeclampsia according to the presence or absence of acute atherosis.

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Table 3. Distribution of acute atherosis according to histologic sections examined in the placenta and placental bed biopsies.

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The frequency of acute atherosis in normal pregnancy and preterm labor, preeclampsia, small-for-gestational age, fetal death and midtrimester spontaneous abortion^*

Table 1. Clinical diagnosis of patients included in the study.

Table 2. Clinical characteristics and pregnancy outcome of patients with preeclampsia according to the presence or absence of acute atherosis.

Table 3. Distribution of acute atherosis according to histologic sections examined in the placenta and placental bed biopsies.

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The frequency of acute atherosis in normal pregnancy and preterm labor, preeclampsia, small-for-gestational age, fetal death and midtrimester spontaneous abortion*

Figures & data

Table 1. Clinical diagnosis of patients included in the study.

Table 2. Clinical characteristics and pregnancy outcome of patients with preeclampsia according to the presence or absence of acute atherosis.

Table 3. Distribution of acute atherosis according to histologic sections examined in the placenta and placental bed biopsies.

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The frequency of acute atherosis in normal pregnancy and preterm labor, preeclampsia, small-for-gestational age, fetal death and midtrimester spontaneous abortion^*