The human placenta. Anatomy and morphology.
This review presents basic aspects of placental morphology with particular reference to the regional specialization of human placental tissues. Intrauterine visualization of the placenta is now possible with new non-invasive methods. Echotomographic ultrasound images of the placenta in vivo and in vitro are of the greatest value for clinical and pathological diagnosis. X-ray computed tomography, though it cannot be applied to pregnant women, is invaluable for the study of circulatory and pathologic changes in the placenta isolated post partum. Nuclear magnetic resonance imaging is another useful adjunct not only for placental localization but also to detect changes of placental morphology with an accuracy almost as good as ultrasonography. Fourier-transform spectroscopy now offers a unique opportunity to obtain computed biochemical data on the metabolic evolution of the human placenta.
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ABSTRACT: Imaging the placenta during its intrauterine development and maturation can be performed using various “non invasive” methods: femoral retrograde angiography, computer assisted x-ray tomography, radionuclide scintigraphy, ultrasonography, and magnetic resonance imaging. All can localize the placental site and, to a valuable degree, image the placental architecture in situ and in vitro post partum (Panigel, 1986b; Panigel et al., 1986a).
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ABSTRACT: Our objective was to study the endothelial status of the luminal lining of uteroplacental vessels in the human placental bed in normal and abnormal pregnancy in the third trimester. Six placental basal plates from uncomplicated pregnancies and five from pregnancies complicated by preeclampsia (n = 3), preeclampsia and a small-for-gestational-age infant (n = 1), and diabetes mellitus (n = 1) were accessioned from the archives because of documentation of their containing uteroplacental vessels. Five placental bed biopsy specimens with intraluminal endovascular trophoblast in the third trimester were also studied. Sections were subjected to immunohistochemical analysis with monoclonal and polyclonal antibodies labeling endothelium and trophoblast. In third-trimester normal uncomplicated pregnancies the uteroplacental arteries and veins were completely endothelialized with no disruption of the endothelium. In third-trimester abnormal pregnancies the uteroplacental veins were also completely endothelialized. However, intraluminal endovascular trophoblast was seen within the uteroplacental arteries in eight of the 10 complicated pregnancies; this finding was associated with disruption of the endothelium. In preeclampsia there is an aberrant wave of endovascular trophoblast migration in the third trimester, resulting in focal disruption of the endothelium. This may be responsible for the endothelial cell dysfunction thought to be of pathogenetic importance in preeclampsia.
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