ABSTRACT
Three groups of placentae from 27 cases of cytomegalovirus infection were examined morphologically and by specific immunofluorescence. Placentae in Group 1 (four cases) had a mean gestational age of 24.5 +/- 2.5 weeks; those in Group 2 (11 cases) had a mean gestational age of 36.4 +/- 2.7 weeks; those in Group 3 (12 cases) had a mean gestational age of 40 +/- 1.8 weeks. A tendency towards increased placental weight was observed. In 23 cases, a haematogenous placentitis was suspected on gross examination. Some specific features were detected on light microscopy. In Group 1 the lesions were represented by pronounced dysmaturity of villous structures, diffuse reparative villitis and intervillitis allied to an abundance of cytomegalic cells and areas of necrosis and calcification. In Group 2 a chronic active process was indicated by the presence of vascular involvement, proliferative-necrotic and reparative villitis and fresh villous necrosis; cytomegalic cells were scarce. In Group 3 placentae there was a predominance of villous plate lesions similar to those found in the septicaemic phase of maternal infections; necrotizing, proliferative and, rarely, reparative villitis was present; cytomegalic cells were rare. We may conclude that placental morphology needs to be substantiated by special laboratory techniques for the detection of cytomegalovirus infection.
Subject(s)
Cytomegalovirus Infections/pathology , Placenta/pathology , Pregnancy Complications, Infectious/pathology , Adolescent , Adult , Female , Fluorescent Antibody Technique , Humans , Organ Size , PregnancyABSTRACT
Two groups of placentae from 18 cases of maternal rubella were examined morphologically and virologically. Placentae in Group I (four cases) had a mean gestational age of 21 +/- 1.9 weeks, whilst those in Group 2 (14 cases) had a mean gestational age of 38 +/- 2.8 weeks. A tendency to hypoplasia was observed. The microscopic lesions were similar to those found in other viral infections but in each group some specific features were noted. Only placentae of Group I showed nodules of villi agglutinated by fibrin. This lesion suggested recent maternal infection. Attention is drawn to the presence of abnormal areas of lobular rarefaction due to dysmaturity of villous stem and terminal villi. This aspect was more diffuse and accentuated in Group 2 placentae. Villitis of reactive, necrotic, proliferative and reparative types was seen only in placentae of Group 2. Devastating villitis was not observed. Inclusions in placental cells suggested rubella infection. The lesions were non-specific and hence stress the need for virological examination of the placenta, immunofluorescence studies and electron microscopy to confirm the diagnosis.
Subject(s)
Placenta/pathology , Pregnancy Complications, Infectious/pathology , Rubella/congenital , Adult , Chorionic Villi/pathology , Cytopathogenic Effect, Viral , Female , Fluorescent Antibody Technique , Humans , Pregnancy , Rubella/pathologyABSTRACT
The histopathologic study of 3 cases of gestational mumps is presented. The tissue studies was obtained from a spontaneous abortion (case 1) and from 2 therapeutic abortions (cases 2 and 3). Severe placental and fetal lesions were observed, indicating a probable association with maternal mumps. The main placental lesion was a diffuse proliferative necrotic villitis with severe lesions in the fetal vascular circuit, probably the cause of death. In the fetal viscera, areas of necrosis and mineralization were observed. Viral inclusions identical to those described in mumps infection were observed in the chorionic and fetal tissues.
