ABSTRACT
El objetivo del estudio fue comparar el índice de madurez placentaria y las alteraciones histopatológicas en placentas de recién nacidos/óbitos con y sin defecto congénito (DC). Se realizó un estudio tipo casos y controles. Se incluyeron n=25 casos yn=50 controles sin DC. Los casos se clasificaron de acuerdo a la presencia de DC aislado (n=17) omúltiple (n=8). Se incluyeron recién nacidos/óbitos (RN) con una edad gestacional (EG) > 20 semanas. Se excluyeron embarazos gemelares. Se recolectó información sobre las características clínicas del producto y de la madre, antropometría del RN y su evaluación de APGAR. Se examinó la placenta, macroscópica y microscópicamente, para determinar la presencia y extensión de alteraciones histopatológicas. Se determinó el índice de madurez placentaria (IMP), calculado dividiendo el número de membranas vásculo sinciciales en 1 mm2 entre el grosor de las mismas (µ). El IMP (media ±DE) fue de 27.77±14 en el grupo de controles, 30.31±12 en el grupo de casos aislados y 16.76± 1 en el grupo de DC múltiple (p<0.05).El resto de las variables evaluadas no mostraron diferencias significativas entre grupos. En conclusión este trabajo muestra una menor madurez placentaria asociada con la presencia de DC múltiple.
The objective of the study was to compare the placental maturity index (PMI) and pathohistological alterations of placentas from newborn/stillborns (NB) with or without congenital defects (CD). A case control study was carried out. N=25 CD cases and n=50 controls without CD were included. Cases were classified according to the presence of simple (n=17) or multiple (n=8) CD. Newborn/stillborns with gestational age >20 weeks were included. Twin pregnancies were excluded. We collected information on clinical characteristics of the NB and the mother, NB anthropometry and APGAR score. The placenta was macro and microscopically examined to determine the presence and extension of histological alterations. The PMI was obtained by dividing the number of vasculo-syncytial membranes in 1 mm2, by their thickness (µ). The PMI (Mean ± SD) was 27.77 ± 14 in the control group, 30.31 ± 12 in the group diagnosed with simple CD, and 16.76 ± 1 in the group diagnosed with multiple CD (p<0.05. The rest of the assessed variables did not show significant difference between groups. In conclusion, this work shows a lower placental maturity associated with the presence of multiple CD.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Congenital Abnormalities/epidemiology , Placenta/pathology , Case-Control StudiesABSTRACT
The aim of this study was to pattern macroscopically, by use of computational tools, the number and distributionof the medullary striae (MS) of fourth ventricle. After removing 71 fresh human brain stems, each respectiverhomboid fossa was photographed. The MS were carefully identified to be shaped and fulfilled by means ofa digital pen, using the Adobe Photoshop CS3® program. For absolute and relative analyses of number anddistribution, it was considered the maximum and minimum numbers of striae; striae that reached the ipsilaterallateral recess; presence of horizontal or oblique striae, with or without parallelism; and striae located at pontineor bulbar part of the rhomboid fossa. At least two MS per side were macroscopically detectable in 90.6% ofcases; they were bilaterally absent in 5.3% of pieces; and at least one medullary stria was present in both sidesof the rhomboid fossa in 92% of cases. As on the right side (36% of cases) as on the left (26.6%), two MS werefrequently more present. In 60% of cases, striae reached ipsilateral lateral recess on the left, and in 40% of caseson the right. It was detected horizontal, (non-parallel) oblique and parallel striae in 50.7, 86.7 and 26.7%of cases, respectively. Medial medullary striae were observed in the bulbar part of rhomboid fossa in 80% ofpieces, and in 36% of cases in the pontine part. The MS of fourth ventricle show high morphological variabilitydegree in relation to number and distribution.