Corangioleiomioma placentario / Placentary chorangio-leiomyoma

Los corangiomas son los tumores placentarios no trofoblásticos más frecuentes; generalmente aparecen como hallazgos al momento del alumbramiento. La presencia de leiomiomas en las placentas también ha sido descripta esporádicamente, siendo por lo general tumores maternos uterinos incorporados a la placenta durante la gestación. En este trabajo se informa un caso muy inusual de lesión mesenquimática, localizada en la cara fetal placentaria, caracterizada por la combinación de rasgos histopatológicos e inmunohistoquímicos de corangioma y leiomioma. Se encontró un solo caso informado en la bibliografía científica internacional con estas características, denominado "corangioleiomioma". En nuestro conocimiento, el caso aquí expuesto es el primero comunicado en nuestro país.

Chorangiomas are the most common non-trophoblastic tumors, generally appearing as incidental findings at the moment of delivery. The presence of leiomyomas inside placental parenchyma has been also described sporadically. In these cases, leiomyomas were primary maternal uterine neoplasms incorporated into the placenta during pregnancy. This case report presents a very unusual case of mesenchymal lesion, located in the fetal surface of the placenta, characterized by combined histopathologic and immunohistochemical features of chorangioma and leiomyoma. A single case reported with these characteristics was found in the international scientific literature, named as "chorangioleiomyoma". To our knowledge, this is the first case reported in our country.

Quistes subamnióticos en el contexto de restricción de crecimiento fetal / Subamniotic cysts in the context of growth restriction fetal

RESUMEN La restricción de crecimiento fetal (RCF) es el término con el que se define a aquellos fetos que no alcanzan el potencial de crecimiento intraútero esperado debido a factores genéticos o ambientales. Dentro de las causas de RCF asociadas a la placenta encontramos mosaicismo confinado a la misma, enfermedad isquémica placentaria y anomalías estructurales a este nivel. Se presenta el caso de una paciente de 32 años con diagnóstico de RCF que asocia múltiples quistes econegativos subamnióticos en la cara fetal de la placenta. Se finaliza la gestación en semana 34 mediante cesárea electiva por ausencia de diástole en el estudio Doppler de la arteria umbilical, evidenciando cinco quistes subamnióticos de 4 a 6 cm que alteran la superficie del amnios.

ABSTRACT Fetal growth restriction (FGR) is the term used to define those fetuses that do not reach the expected intrauterine growth potential due to genetic or environmental conditions. The causes of FGR associated with the placenta are confined placental mosaicism, placental ischemic disease and placental structural abnormalities. We report a case of a 32-year-old patient with a diagnosis of FGR associated with multiple subamniotic econegative cysts overlaying the fetal plate of the placenta. The gestation is ended in week 34 by elective cesarean section due to absence of diastolic flow in the umbil-ical artery, showing five subamniotic cysts from 4 to 6 cm that disrupt the surface of the amnion.

Fetal thrombotic vasculopathy: A case report and literature review / Vasculopatia trombótica fetal: relato de caso e revisão da literatura

Summary Introduction: Fetal thrombotic vasculopathy is a recently described placental alteration with varying degrees of involvement and often associated with adverse perinatal outcomes. The diagnosis is made histologically and therefore is postnatal, which makes it a challenge in clinical practice. Method: Case report and review of literature on the subject. Results: The present case refers to a pregnant woman presenting fetal growth restriction, with poor obstetrical past, and sent late to our service. Even with weekly assessments of fetal vitality (fetal biophysical profile and Doppler velocimetry) and prenatal care, the patient progressed with fetal death at 36 weeks and 1 day. There was no association with inherited and acquired thrombophilia. Pathological examination of the placenta revealed fetal thrombotic vasculopathy. Conclusion: The fetal thrombotic vasculopathy may be associated with adverse perinatal outcomes including fetal death, but much remains to be studied regarding its pathogenesis. Diagnosis during pregnancy is not possible and there is still no proven treatment for this condition. Future studies are needed so that strategies can be developed to minimize the impact of fetal thrombotic vasculopathy.

Resumo Introdução: a vasculopatia trombótica fetal é uma alteração placentária recentemente descrita, com espectro variado de acometimento e, muitas vezes, associada a resultado perinatal adverso. Trata-se de diagnóstico histopatológico e, portanto, pós-natal, o que a torna um desafio para a prática clínica. Método: apresentação de um relato de caso e revisão da literatura. Resultados: o caso apresentado é de uma gestante com restrição do crescimento fetal, encaminhada tardiamente ao serviço, com histórico obstétrico ruim. Apesar da avaliação semanal da vitalidade fetal (perfil biofísico fetal e dopplervelocimetria) e dos cuidados pré-natais, o caso evoluiu a óbito fetal com 36 semanas e 1 dia. Não houve associação com trombofilias hereditárias e adquiridas. O anatomopatológico da placenta revelou vasculopatia trombótica fetal. Conclusão: sabe-se que a vasculopatia trombótica fetal pode estar associada a resultado perinatal adverso, incluindo óbito fetal. Ainda há muito a ser estudado acerca de sua etiopatogenia. Não é possível o diagnóstico durante a gestação e não existe ainda qualquer tratamento comprovado para essa condição. Estudos futuros são necessários para que estratégias que minimizem o impacto da vasculopatia trombótica fetal sejam desenvolvidas.

Evaluation of a father and son with atypical chronic myeloid leukemia with SETBP1 mutations and a review of the literature

We report the case of a father and son diagnosed with atypical chronic myeloid leukemia (aCML). Both patients harbored SETBP1 mutations, which are present in 24.3% of aCML patients. Moreover, both shared the variant encoding p.Pro737His, but the aCML severity was greater in the son because of the presence of two other missense mutations causing p.Asp868Asn and p.Ser885Arg alterations. SETBP1 mutations may be associated with an adverse prognosis, so their detection would help in the diagnosis of aCML and the determination of a patient's prognosis.

Displasia mesenquimal placentaria: caso clínico / Placental mesenchymal dysplasia: a case report

La displasia mesenquimal placentaria es una entidad poco conocida, de etiología incierta y subdiagnosticada. Frecuentemente, es confundida con enfermedad trofoblástica gestacional debido a que se presenta con hallazgos ultrasonográficos caracterizados por una placenta engrosada, con quistes e imágenes hipoecogénicas y niveles de gonadotrofina coriónica humana normales o levemente aumentados. El feto es frecuentemente viable y puede manifestar retraso del crecimiento intrauterino, prematurez o asociarse al síndrome de Beckwith-Wiedemann. Se presenta el caso de una mujer joven con un parto pretérmino con placentomegalia, sospecha de mola hidatidiforme parcial y un recién nacido pequeño para la edad gestacional.

The placental mesenchymal dysplasia is a not well known entity, with an uncertain etiology and under diagnosed. It is frequently confused with gestational trophoblastic disease because of its ultrasonographic features of a thick placenta, cysts and hypoechogenic images, with normal or slightly increased levels of human chorionic gonadotrophic hormone. The fetus is often viable and can manifest intrauterine growth restriction, prematurity or be associated with Beckwith-Wiedemann syndrome. We present a case report of a young woman with a preterm delivery, placentomegaly, suspicious of a partial hydatidiform mole and a low growth newborn.

Asociación entre lesiones placentarias y lesiones isquémico hemorrágicas cerebrales precoces detectadas por ecografía en prematuros menores de 1500 gramos y 32 semanas / [The relationship between placental lesions and early hemorrhagic-ischemic cerebral injury in very low birth weight infants].

INTRODUCTION: The histopathological features of the placenta are central for screening a lot of pregnancy related disorders associated to hemorrhagic-ischemic cerebral injury in preterm infants that can jeopardize his long term neurodevelopment. The objective of this study was to examine the relationship between placental lesions and early hemorrhagic-ischemic cerebral injury in very low birth weight infants (VLBW). METHODS: This is a case-control study of VLBW born at Sardá Maternity Hospital, Buenos Aires, between 2006 and 2012. Inclusion criteria’s were gestational age ÔëÑ 24 and Ôëñ 32 weeks and birth weight between 500 g and 1500 g, Exclusion criteria’s were multiple pregnancy, congenital anomalies, intrauterine infections and mortality before 24 hours of life. RESULTS: 198 VLBW were included, 49 cases and 149 controls. There was no significant difference in the incidence of histopathological lesions between the groups, although inflammatory placental lesions predominated in cases (67,3

) compared with controls (48

, p= 0.018). Intraventricular hemorrhage was the most common injury. On bivariate analysis inflammation was the only placenta lesion associated with early hemorrhagic-ischemic cerebral injury (OR 7.0, 95

CI 1.54 - 31.71) whereas the risk of severe hemorrhagic-ischemic cerebral injury was twofold greater in the presence of inflammation (p= 0.20). After adjusting for perinatal variables, placental lesions were not independently associated with increased risk of hemorrhagic-ischemic cerebral injury. There was a trend towards lesser risk of hemorrhagic-ischemic cerebral injury with increasing gestational age. CONCLUSION: Placental injuries were not independently associated with hemorrhagic-ischemic cerebral injury within 72 hours of life, although inflammation showed a clear predominance un cases.

Spectrum of changes in placenta in toxemia of pregnancy.

Background: Toxemia of pregnancy is the leading cause of maternal mortality and is an important factor in fetal wastage. The incidence is high in developing countries with malnutrition, hypoproteinemia, and poor obstetric facilities. Objectives: The present study was undertaken to analyze placental changes in the preeclampsia-eclampsia syndrome with a view to assess the significance of villous abnormalities by histopathological methods because these changes serve as a guide to the duration and severity of disease. Gross abnormalities noted were the placental infarcts, retroplacental hematoma, and calcification. Results: The striking villous abnormalities observed in the study group were cytotrophoblastic proliferation (86%), thickening of the villous basement membranes (95.23%), increase in syncytial knots (90.4%), villous stromal fibrosis (92%), fibrinoid necrosis (97.82%), endarteritis obliterans (53.96%), decreased villous vascularity, and paucity of vasculosyncytial membranes (93.65%). Conclusions: The gross abnormalities and villous lesions in the preeclampsia (P < 0.001) and eclampsia syndrome (P < 0.05) were significant.

Características histomorfométricas do placentomo de vacas Nelore nos terços inicial, médio e final de gestação / Histomorphometric characteristics of Nelore cows placentome in the initial, middle, and third terms of gestation

Avaliaram-se as características histomorfométricas do placentomo da vaca Nelore nos terços inicial, médio e final da gestação utilizando-se 52 úteros gestantes. Para a estimativa do estádio gestacional, foram utilizados aspectos do desenvolvimento fetal. Foram coletados fragmentos de um placentomo localizado no corno uterino ipsilateral ao corpo lúteo, os quais foram imersos em solução de formol e, posteriormente, processados histologicamente, incluídos em parafina e corados com hematoxilina-eosina. O estudo das proporções volumétricas foi feito utilizando-se microscópio de luz equipado com ocular integradora. Foi feita, também, a quantificação das células epiteliais nas criptas das carúnculas por meio de microscopia de luz e uma ocular micrométrica com 100 divisões. Foi verificado decréscimo no número das células maternas do epitélio das criptas no final da gestação. Os números médios das células binucleadas do trofoblasto, nos terços inicial, médio e final da gestação, mantiveram-se semelhantes, bem como a proporção volumétrica dos componentes dos tecidos conjuntivos materno e fetal e dos vasos no tecido materno. No tecido fetal, ocorreu aumento gradativo do tecido conjuntivo nos terços inicial, médio e final.

Histomorphometric characteristics of the placentome of the Nelore cow in the initial, medium, and final trimesters of pregnancy were evaluated using 52 pregnant uteri. For the estimation of the gestational age, aspects of fetal development were used. Fragments of a placentome of the uterine horn ipsilateral to the corpus luteum, which were immersed in formalin solution were collected, and processed for routine histological technique, included in paraffin, and stained with hematoxylin-eosin. The study of the volumetric proportion was done using a light microscope equipped with an integrated ocular. It was also made the quantification of the epithelial cells in the crypts of caruncles by light microscopy and with the help of a micrometric ocular with a grid of 100 divisions. It was found a decrease in the number of maternal cells of the epithelium in the crypts in advanced pregnancy. The average number of binucleate trophoblast cells remained similar throughout gestation, as well as the volumetric proportion of components of the maternal and fetal connective tissue and maternal blood vessels. For the fetal tissues, there was a progressive increase in the connective tissue in the three trimester of pregnancy.

Trombohematoma subcorionico masivo: una patología placentaria emergente / Massive subchorionic thrombohematoma

El trombohematoma subcoriónico es una extravasación de sangre localizada en la placa coriónica, entre amnios y corion. Es muy infrecuente, el diagnóstico no es común, tiene alto riesgo perinatal y no hay casos comunicados en nuestro medio. Se presentan 12 casos de sospecha diagnóstica antenatal, confirmada en el examen histopatológico placentario. Se describe y discute el cuadro clínico, las complicaciones maternas y perinatales, el diagnóstico ultrasónico, el manejo y los resultados obtenidos. En nueve casos se identifcó una fase latente con hematoma de tamaño estable, entre el inicio de los síntomas y el parto, que duró en promedio 7,3 semanas. En ocho casos la fase latente fue seguida por una fase activa con aumento del hematoma asociado al parto prematuro. Tres embarazadas presentaron patología médica compleja con una muerte materna. Seis casos hicieron anemia severa y tres patología miscelánea. Hubo ocho amenazas de parto prematuro con tocolisis, tres rotura prematura de membranas, una colestasis y una preeclampsia. Los partos fueron prematuros, dos de 36 y 33 semanas y diez menores a 32 semanas. Siete prematuros tuvieron peso inferior a 1000 gramos y seis hicieron restricción fetal grave, en percentil <5 de la curva de crecimiento. Hubo complicaciones neonatales relacionadas con prematurez, restricción y bajo peso, manejados con hospitalización prolongada con promedio de 74 días (rango: 6-298 días). Diez neonatos sobrevivieron; hubo un mortinato y un mortineonato. La sobrevida fue 83,3 por ciento y la mortalidad de 16,6 por ciento que se comparan favorablemente con las cifras comunicadas.

Subchorial thrombohaematoma is caused by blood extravasations in the corionic plate, between amnion and chorion. It is a rare pathologic entity, that carries a high perinatal risk, which has not being published in our country up to now. We report 12 cases in which the diagnosis was suspected before birth, and confirmed in the placentary pathological examination. We describe the clinical presentation, fetal and maternal risks, ultrasonographic findings, treatment and clinical outcomes. In 9 patients a latent phase was identified with a stable size hematoma, which had a mean duration of 7.3 weeks. In 8 cases the latent phase was followed by an active phase, with increasing size of the hematoma associated with preterm labour. Three pregnant women had severe complications which caused one maternal death. Six had severe anemia and other three had minor complications. Eight had preterm labor symptoms which required tocolysis. Three had prelabour rupture of membranes, one cholestasis disease and preeclampsia. Preterm labours were at 36, 33 and other ten before 32 weeks of gestation. Seven preterm newborns weight less than 1000 grams and six had severe fetal restriction (p<5). Newborn complications were related with prematurity, requiring prolonged hospitalization (mean 74 days, range 6-298 days). Ten newborns survived. There were 1 still birth and 1 dead newborn. Survival rate was 83.3 percent and 16.6 percent mortality, better rates than previously published.

Alterações histopatológicas em placentas humanas relacionadas às síndromes hipertensivas / Histopathological changes in human placentas related to hypertensive disorders

OBJETIVO: determinar a prevalência de alterações histopatológicas em placentas humanas, relacionadas às síndromes hipertensivas. MÉTODOS: estudo de corte transversal, que comparou as alterações histopatológicas identificadas em 43 placentas oriundas de gestantes do grupo de hipertensas (GrHip) com as de 33 placentas de gestantes do grupo de normotensas (GrNor). Foram analisados o peso, volume e ocorrência macro e microscópica de infartos, coágulos, hematomas, aterose (obliteração parcial, espessamento de camadas e presença de vasos hialinizados) e alterações de Tenney-Parker (ausentes, discretas e proeminentes), bem como a localização de infartos e coágulos (central, periférico ou associação de ambos). Para a análise estatística foram usados os testes do χ2 e t de Student, bem como médias, desvios padrões e percentuais. Considerou-se como significante um p<0,05. RESULTADOS: o estudo macroscópico revelou que as placentas do GrHip, se comparadas às do GrNor, apresentaram menor peso (461,1 versus 572,1 g) e volume (437,4 versus 542,0 cm³) e percentuais aumentados de infartos (51,2 versus 45,5 por cento; p<0,05; OR=1,15) e de coágulos (51,2 versus 15,1 por cento; p<0,05; OR=5,4). Nos GrHip e GrNor, os infartos microscópicos ocorreram em 83,7 e 45,5 por cento; p<0,05; OR=4,3, respectivamente. A aterose e as alterações de Tenney-Parker associaram-se estatisticamente às síndromes hipertensivas (p<0,05). CONCLUSÕES: os dados obtidos permitem associar menor peso e volume placentário, maior percentual de infartos macro e microscópicos, coágulos, aterose e alterações de Tenney-Parker às placentas relacionadas com gestações que cursaram com síndromes hipertensivas.

PURPOSE: to determine the prevalence of histopathological changes, in human placentas, related to hypertensive syndromes. METHODS: a transversal study that compares histopathological changes identified in 43 placentae from hypertensive pregnant women (HypPr), with the ones from 33 placentae from normotensive pregnant women (NorPr). The weight, volume and macroscopic and microscopic occurrence of infarctions, clots, hematomas, atherosis (partial obliteration, thickness of layers and presence of blood vessels hyalinization) and Tenney-Parker changes (absent, discreet and prominent), as well as the locating of infarctions and clots (central, peripheral or the association of both) have been analyzed. The χ2 and t Student tests have been used for the statistical analysis, as well as medians, standard deviations and ratios. It has been considered as significant, p<0.05. RESULTS: the macroscopic study of HypPr placentae have presented lower weight (461.1 versus 572.1 g) and volume (437.4 versus 542.0 cm³), higher infarction (51.2 versus 45.5 percent; p<0.05: OR=1.15) and clots (51.2 versus 15.1 percent; p<0.05; OR=5.4) ratios, as compared to the NorPr's. In the HypPr and NorPr, microscopic clots have occurred in 83.7 versus 45.5 percent (p<0.05; OR=4.3), respectively. Atherosis and Tenney-Parker changes have been statistically associated to the hypertensive syndromes (p<0.05). CONCLUSIONS: the obtained data allow us to associate lower placentary weight and volume, higher ratio of macro and microscopic infarction, clots, atherosis and Tenney-Parker changes to placentae of gestations occurring with hypertensive syndromes.

Prenatal MRI Findings of Fetuses with Congenital High Airway Obstruction Sequence

OBJECTIVE: To define the MRI findings of congenital high airway obstruction sequence (CHAOS) in a series of fetuses. MATERIALS AND METHODS: Prenatal fetal MR images were reviewed in seven fetuses with CHAOS at 21 to 27 weeks of gestation. The MRI findings were reviewed. The MRI parameters evaluated included the appearance of the lungs and diaphragm, presence or absence of hydrops, amount of amniotic fluid, airway appearance, predicted level of airway obstruction, and any additional findings or suspected genetic syndromes. RESULTS: All the fetuses viewed (7 of 7) demonstrated the following MRI findings: dilated airway below the level of obstruction, increased lung signal, markedly increased lung volumes with flattened or inverted hemidiaphragms, massive ascites, centrally positioned and compressed heart, as well as placentomegaly. Other frequent findings were anasarca (6 of 7) and polyhydramnios (3 of 7). MRI identified the level of obstruction as laryngeal in five cases and tracheal in two cases. In four of the patients, surgery or autopsy confirmed the MRI predicted level of obstruction. Associated abnormalities were found in 4 of 7 (genetic syndromes in 2). Postnatal radiography (n = 3) showed markedly hyperinflated lungs with inverted or flattened hemidiaphragms, strandy perihilar opacities, pneumothoraces and tracheotomy. Two fetuses were terminated and one fetus demised in utero. Four fetuses were delivered via ex utero intrapartum treatment procedure. CONCLUSION: MRI shows a consistent pattern of abnormalities in fetuses with CHAOS, accurately identifies the level of airway obstruction, and helps differentiate from other lung abnormalities such as bilateral congenital pulmonary airway malformation by demonstrating an abnormally dilated airway distal to the obstruction.

Displasia mesenquimatosa de la placenta: caso clínico / Placental mesenchymal dysplasia: case report

Placental mesenchymal dysplasia (PMD) is a rare placental anomaly characterized by placentomegaly and grapelike vesicles resembling a molar placenta by ultrasound. A clinical case is presented and we will discuss the differential diagnosis, possible associations and perinatal management.

La displasia mesenquimatosa de la placenta es una anormalidad rara de la placenta caracterizada por una placenta grande con dilataciones quísticas similares a una mola parcial a la ultrasonografía. Se presenta un caso clínico y se discutirá el diagnóstico diferencial, posible asociaciones y manejo perinatal.

Study of placenta in sickle cell disorders.

Remarkable changes are seen on gross and microscopic examination of placenta of patients with sickle cell disorders, hence the present study was undertaken to find out the pathological changes seen in the placenta of sickle cell disorder patients, as compared to control and to study the effect of maternal sickling on the fetus. It includes total 73 cases, of which 10 were of control group and 63 were from patients with sickle cell disorders, which included 47 sickle cell trait (AS) and 16 sickle cell disease (SS) patients. In group II, 9 (14.28%) patients with SS pattern developed complications during pregnancy, in the form of vaso-occlusive and hemolytic crises. Pregnancy induced hypertension was seen in 4 (25%) out of 16 SS and 11 (23.40%) of the 47 AS patients. Urinary tract infection (UTI) was seen in 6 (37.5%) out of 16 SS and 8 (17.02%) out of 47 AS patients. Placentae in sickle cell disorders showed pathological changes in the form of infarction, calcification, sickled red blood cells and hemorrhage in intervillous spaces, increased syncytial knots, fibrinoid necrosis, stromal fibrosis, hyalinised villi and compensatory proliferation of trophoblastic cells.

Diffuse multifocal chorangiomatosis of the placenta with multiple intestinal stenosis of the fetus: combination of rare causes for nonimmune hydrops fetalis.

Non-immune causes of hydrops fetalis are rare but frequently fatal. Identification of the cause for hydrops fetalis is essential to institute therapy. Chorangiomatosis and intestinal stenosis have not been previously reported as aetiological factors for the development of hydrops. We report a fetus born with hydrops associated with both of these conditions. A 1575 gms preterm neonate was born to a multigravida at 31 weeks of gestation. Emergency caesarean section was performed after detection of hydrops by prenatal ultrasonography. Baby had generalized edema at birth and died after 3 days due to progressive heart failure. At autopsy there was generalized edema and effusions. There were multiple stenotic segments in the intestine. Placenta showed numerous chorangiomas varying from 0.2 to 3 cm in diameter, hence diagnosed as diffuse multifocal chorangiomatosis. Examination of the placenta at neonatal autopsy is an essential part of assessment for hydrops fetalis. Chorangiomatosis is a rare and under reported condition which can cause prematurity, intrauterine growth retardation, pre-eclampsia and rarely hydrops fetalis.

Prevalencia de la infección transplacentaria por Trypanosoma cruzi en el Hospital de Calama, II Región - Chile / Prevalence of the transplacentary infection for Trypanosoma cruzi in the Calama Hospital, II Region - Chile

Desde 1997, INCOSUR ha propuesto incorporar a las actividades de control, los programas que realicen los diversos países para intervenir la transmisión transplacentaria del Trypanosoma cruzi. El presente estudio tuvo como propósito conocer, diagnosticar y tratar los casos de enfermedad de Chagas congénita en la II Región de Chile, para lo que se estudiaron los 1.987 partos producidos en un año cronológico en uno de sus hospitales más importantes. De los 1.987, 45 casos resultaron positivos (2,4 por cento) para la infección por el T. cruzi y la transmisión transplacentaria se produjo en 5 niños (11 por cento). Todos los niños fueron asintomáticos al nacer, se trataron médicamente con Nifurtimox y al cabo de un año todos presentaron cura serológica y parasitológica la cual fué corroborada durante 2 años de seguimiento. El estudio epidemiológico de los casos índices permitió detectar otros 8 niños infectados, los cuales también fueron tratados, obteniéndose una cura serológica y parasitológica en 50 por cento de los casos a los dos años de control. De acuerdo a los resultados se recomienda la implementación de un programa de intervención de la infección transplacentaria por Trypanosoma cruzi en las áreas de endemia chagásica de Chile.

Feto-placentary pathology in human parvovirus B (19) infection

Sao escassas as referencias aos dados histologicos relativos a infeccao congenita pelo parvovirus humano B(19). Apresentamos estudo morfologico de seis autopsias em que o virus foi detectado por hibridizacao DNA (HIS-HDB), PCR e microscopia eletronica (ME) em tecidos feto-placentarios fixados em formol e incluidos em parafina. Estas autopsias integravam um grupo de 86 Hidropisias Fetais nao Imunologicas (HFNI) que apresentaram a microscopia optica complexo lesional sistemico inflamatorio/degenerativo de causa indeterminada. Em uma crianca detectou-se processo sifilitico multivisceral com microorganismos, caracterizando infeccao dupla. Os fetos exibiram quadro semelhante: hidropisia, hepato-esplenomegalia, hipoplasia pulmonar e eritroblastemia...

Hallazgos ultrasónicos en borregas preñadas infectadas con Chlamydia psittaci / Ultrasonic findings in pregnant ewes infected with Chlamidia psittaci

Introducción. La ultrasonografía es un método de examen que puede ser empleado para el diagnóstico de diversos procesos patológicos que ocurren en el útero de animales gestantes, incluso antes de que se observen signos clínicos de la enfermedad. El objetivo de este estudio fue determinar la utilización del ultrasonido para diagnosticar procesos patológicos que ocurren en el útero de borregas gestantes infectadas con Chlamydia psittaci para evaluar el desarrollo placentario. Material y métodos. Se inocularon cinco animales en el día 80 de gestación con 1x10 ala 7 unidades de inclusión de una cepa abortiva de C. psittaci. Cinco borregas no fueron inoculados y permanecieron como controles. Una vez a la semana se realizó un examen ultrasonográfico a todas las borregas para evaluar el desarrollo placentario y parto normal. Las placentas se encontraron sin lesiones macroscópicas aparentes. En tres borregas inoculadas se observaron al ultrasonido lesiones placentarias entre los 13 y 23 días posinoculación. Una abortó y dos tuvieron cría débiles; todas sus placentas mostraron necrosis y engrosamiento típicos de la infección con C. psittaci. Se aisló en la placenta C. psittaci en cuatro de cinco borregas inoculadas fueron ocasionadas por la infección de C. psittaci. Estas lesiones típicas observadas en las placentas después del parto y el aborto fueron visualizadas por ultrasonografía por ser de alta ecogenicidad, lo que avala la utilidad de ese método diagnóstico en esta condición patológica

Correlación clínico macromicroscopica placentaria / Placental clinical and macroscopic correlation

El presente trabajo retrospectivo de seguimientos lineal, fue realizado en la Maternidad Germán Urquidi, servicio de GOB y Laboratorio, Bio-Médico (LAMIMED) de la UMSS. Se estudiaron 350 placentas en pacientes que acudieron al servicio para atención de parto y cesárea e incluidas en el programa chagas congénito de la UMSS. Tomando en cuenta los antecedentes clínico-laboratoriales y la correlación macro-microscópica demostró que gran porcentaje de placentan patología, aun en pacientes sin antecedentes clínicos, se hizo mayor énfasis en enfermedades y poco diganósticadas en nuestro medio. Cabe remarcar que la correlación macro-microscópica se realizo en 83 pacientes número de pacientes estudiados en el programa de chagas congénito. De las 350 pacientes estudiadas se demostró patología laboratorial en el 50.8 por ciento, patología clínica el 24.3 por ciento que corresponden al 75 por ciento del total de las pacientes estudiadas. De las 83 pacientes estudiados por microscopía se tienen datos concluyentes, el 100 por ciento de estas placentas presentran alteraciones, algunas específicas como la sífilis que de 8 pacientes, 4 mostraban lesiones sugerentes en el 50 por ciento, el resto también pero con probable asociación patológica que no de detectó por no contar con tinciones especiales para bacterias. En chagas de 28 pacientes con serología positiva sólo en el 4.3 por ciento se detectó parásitos, el resto lesiones microscópicas pero no especifícas. En las pacientes con diagnóstico clínico de eclampsia, en una paciente con preeclampsia moderada, no se detectó alteraciones vasculares típicas que corresponden al 75 por ciento.