Faisal Qureshi

Wayne State University, Detroit, Michigan, United States

Are you Faisal Qureshi?

Claim your profile

Publications (108)288.65 Total impact

  • Suzanne M Jacques · Faisal Qureshi
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Complete placental abruption results rapidly in fetal death through acute asphyxia, and identification of thymic lesions at autopsy may help in confirming this diagnosis. Thymic petechiae are a marker for acute asphyxia, while absence of histologically identifiable acute thymic involution (ATI), which requires several hours to develop, may help in exclusion.Methods: We identified autopsies on 17 3rd trimester stillborns with clinical abruption; 58 stillborns with unexplained demise comprised the control group. Eighty-nine percent of the mothers were African–American. ATI was graded 0–4 (grades 0–1 and 3–4 were combined for analysis), and thymic petechiae were recorded.Results: In the abruption group, ATI grade 0–1 was more frequent than higher grades: 13 (77%) had ATI grade 0–1 compared to 1 (6%) with ATI grade 3–4 (p < 0.001). In contrast, in the control group, ATI grade 3–4 was more frequent than lower grades: 9 (16%) had ATI grade 0–1 compared to 30 (52%) with ATI grade 3–4 (p < 0.001). Thymic petechiae were more frequent in the abruption compared to control group [10 (59%) versus 2 (3%)] (p < 0.001), and were frequently seen with low ATI grade: 10 (83%) had ATI grade 0–1 (p < 0.001).Conclusions: The presence of thymic petechiae and ATI grade 0–1 correlates significantly with a clinical diagnosis of placental abruption.
    No preview · Article · Nov 2015 · Journal of Maternal-Fetal and Neonatal Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Neonates born to mothers with clinical chorioamnionitis at term are at an increased risk of infection. Acute subchorionitis, chorioamnionitis, and funisitis are considered placental histologic features consistent with acute inflammation according to the Society for Pediatric Pathology. The objectives of this study were to examine the performance of placental histologic features in the identification of: 1) microbial-associated intra-amniotic inflammation (intra-amniotic infection); and 2) fetal inflammatory response syndrome (FIRS). This retrospective cohort study included women with the diagnosis of clinical chorioamnionitis at term (n=45), who underwent an amniocentesis to determine: 1) the presence of microorganisms using both cultivation and molecular biologic techniques [polymerase chain reaction (PCR) with broad range primers]; and 2) interleukin (IL)-6 concentrations by enzyme-linked immunosorbent assay (ELISA). The diagnostic performance (sensitivity, specificity, accuracy, and likelihood ratios) of placental histologic features consistent with acute inflammation was determined for the identification of microbial-associated intra-amniotic inflammation and FIRS. 1) The presence of acute histologic chorioamnionitis and funisitis was associated with the presence of proven intra-amniotic infection assessed by amniotic fluid analysis; 2) funisitis was also associated with the presence of FIRS; 3) the negative predictive value of acute funisitis ≥stage 2 for the identification of neonates born to mothers with intra-amniotic infection was
    No preview · Article · Sep 2015 · Journal of Perinatal Medicine

  • No preview · Article · Jul 2015 · European journal of obstetrics, gynecology, and reproductive biology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Most anti-angiogenic preeclampsia models in rodents utilized the overexpression of a truncated soluble fms-like tyrosine kinase-1 (sFlt-1) not expressed in any species. Other limitations of mouse preeclampsia models included stressful blood pressure measurements and the lack of postpartum monitoring. We aimed to 1) develop a mouse model of preeclampsia by administering the most abundant human placental sFlt-1 isoform (hsFlt-1-e15a) in preeclampsia; 2) determine blood pressures in non-stressed conditions; and 3) develop a survival surgery that enables the collection of fetuses and placentas and postpartum (PP) monitoring. Methods: Pregnancy status of CD-1 mice was evaluated with high-frequency ultrasound on gestational days (GD) 6 and 7. Telemetry catheters were implanted in the carotid artery on GD7, and their positions were verified by ultrasound on GD13. Mice were injected through tail-vein with adenoviruses expressing hsFlt-1-e15a (n = 11) or green fluorescent protein (GFP; n = 9) on GD8/GD11. Placentas and pups were delivered by cesarean section on GD18 allowing PP monitoring. Urine samples were collected with cystocentesis on GD6/GD7, GD13, GD18, and PPD8, and albumin/creatinine ratios were determined. GFP and hsFlt-1-e15a expression profiles were determined by qRT-PCR. Aortic ring assays were performed to assess the effect of hsFlt-1-e15a on endothelia. Results: Ultrasound predicted pregnancy on GD7 in 97% of cases. Cesarean section survival rate was 100%. Mean arterial blood pressure was higher in hsFlt-1-e15a-treated than in GFP-treated mice (∆MAP = 13.2 mmHg, p = 0.00107; GD18). Focal glomerular changes were found in hsFlt-1-e15a -treated mice, which had higher urine albumin/creatinine ratios than controls (109.3 ± 51.7 μg/mg vs. 19.3 ± 5.6 μg/mg, p = 4.4 x 10(-2); GD18). Aortic ring assays showed a 46% lesser microvessel outgrowth in hsFlt-1-e15a-treated than in GFP-treated mice (p = 1.2 x 10(-2)). Placental and fetal weights did not differ between the groups. One mouse with liver disease developed early-onset preeclampsia-like symptoms with intrauterine growth restriction (IUGR). Conclusions: A mouse model of late-onset preeclampsia was developed with the overexpression of hsFlt-1-e15a, verifying the in vivo pathologic effects of this primate-specific, predominant placental sFlt-1 isoform. HsFlt-1-e15a induced early-onset preeclampsia-like symptoms associated with IUGR in a mouse with a liver disease. Our findings support that hsFlt-1-e15a is central to the terminal pathway of preeclampsia, and it can induce the full spectrum of symptoms in this obstetrical syndrome.
    No preview · Article · Apr 2015 · PLoS ONE
  • Suzanne M Jacques · William J Kupsky · Faisal Qureshi
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Many third trimester stillbirths are unexplained, including the time course of illness. Histologic acute thymic involution (ATI) when graded, correlates with duration of acute illness (grade 0 <12 hrs; grade 4>72 hours). Histologic brain injury is also common in stillbirth. We investigate ATI in unexplained stillbirth, and correlate it with neuropathological injury. Design: We identified autopsies of unexplained third trimester stillborns that included brain examination, and graded ATI from 0 (resting state) to 4 (pronounced lymphodepletion). Gray matter injury (GMI) and white matter injury (WMI) were classified as older, recent, or absent. ATI was correlated with GMI, WMI, thymic weight and clinical data. Results: We identified 58 autopsies (24 preterm and 34 term). 9 (16%) had ATI grade 0-1, 19 (33%) grade 2, 24 (41%) grade 3, and 6 (10%) grade 4. Thymic weight decreased with increasing ATI grade (p=0.082, indicating trend). Older GMI and WMI were present in 39 (67%) and 10 (17%) stillborns, respectively. Higher ATI grade correlated significantly with older GMI (p<0.001) and WMI (p = 0.014). ATI grade was higher in the small-for-gestational stillborns compared to the appropriate- or large-for-gestational stillborns (p=0.017), but did not correlate significantly with gestational age, or with other clinical or demographic factors evaluated. Conclusions: ATI grade 2-4 was found in 84% of the stillborns, consistent with onset of acute illness 24->72 hrs before demise. Higher ATI grade correlated significantly with older GMI/WMI, suggesting similar time of onset and shared underlying pathophysiologic events, the specific nature of which remains unclear.
    No preview · Article · Feb 2015 · Pediatric and Developmental Pathology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Soluble fms-like tyrosine kinase (sFlt)-1-e15a, a primate-specific sFlt-1-isoform most abundant in the human placenta in preeclampsia, can induce preeclampsia in mice. This study compared the effects of full-length human (h)sFlt-1-e15a with those of truncated mouse (m)sFlt-1(1-3) used in previous preeclampsia studies on pregnancy outcome and clinical symptoms in preeclampsia. Methods Mice were injected with adenoviruses or fiber-mutant adenoviruses overexpressing hsFlt-1-e15a, msFlt-1(1-3) or control GFP under the CMV or CYP19A1 promoters on gestational day 8 (GD8) and GD11. Placentas and pups were delivered by cesarean section, and dams were monitored postpartum. Blood pressure was telemetrically recorded. Urine samples were collected with cystocentesis and examined for albumin/creatinine ratios. Tissue specimens were evaluated for transgene as well as endogenous mFlt-1 and msFlt-1-i13 expression. H&E-, Jones- and PAS-stained kidney sections were histopathologically examined. Placental GFP expression and aortic ring assays were investigated with confocal microscopy. Results Mean arterial blood pressure (MAP) was elevated before delivery in hsFlt-1-e15a-treated mice compared to controls (GD18: ΔMAP = 7.8 mmHg, p = 0.009), while ΔMAP was 12.8 mmHg (GD18, p = 0.005) in msFlt-1(1-3)-treated mice. Urine albumin/creatinine ratio was higher in hsFlt-1-e15a-treated mice than in controls (GD18, p = 0.04; PPD8, p = 0.03), and msFlt-1(1-3)-treated mice had marked proteinuria postpartum (PPD8, p = 4×10−5). Focal glomerular changes were detected in hsFlt-1-e15a and msFlt-1(1-3)-treated mice. Aortic ring microvessel outgrowth was decreased in hsFlt-1-e15a (p = 0.007) and msFlt-1(1-3)-treated (p = 0.02) mice. Full-length msFlt-1-i13 expression was unique for the placenta. In hsFlt-1-e15a-treated mice, the number of pups (p = 0.046), total weight of living pups (p = 0.04) and maternal weights (p = 0.04) were higher than in controls. These differences were not observed in truncated msFlt-1(1-3)-treated mice. Conclusions Truncated msFlt-1(1-3) simulated the preeclampsia-promoting effects of full-length hsFlt-1. MsFlt-1(1-3) had strong effect on maternal endothelium but not on placentas and embryos. In contrast, hsFlt-1-e15a induced preeclampsia-like symptoms; however, it also increased litter size. In accord with the predominant placental expression of hsFlt-1-e15a and msFlt-1-i13, full-length sFlt-1 may have a role in the regulation of embryonic development. These observations point to the difference in the biological effects of full-length and truncated sFlt-1 and the changes in the effect of full-length sFlt-1 during pregnancy, and may have important implications in the management of preeclampsia.
    Full-text · Article · Nov 2014 · PLoS ONE
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: Acute atherosis is characterized by subendothelial lipid-filled foam cells, fibrinoid necrosis and perivascular lymphocytic infiltration. This lesion is generally confined to non-transformed spiral arteries and is frequently observed in patients with preeclampsia. However, the frequency of acute atherosis in the great obstetrical syndrome is unknown. The purpose of this study was to determine the frequency and the topographic distribution of acute atherosis in the placentas and placental bed biopsy samples obtained from women with normal pregnancy and those affected by the great obstetrical syndromes. We also examined the relationship between acute atherosis and pregnancy outcome in patients with preeclampsia. Material and methods: A retrospective cohort study of pregnant women who delivered between July 1998 and July 2014 at Hutzel Women's Hospital/Detroit Medical Center was conducted examine 16,345 placentas. Patients were classified into the following groups: 1) uncomplicated pregnancy; 2) spontaneous preterm labor and preterm prelabor rupture of membranes (PPROM); 3) preeclampsia; 4) gestational hypertension; 5) small for gestational age; 6) chronic hypertension; 5) fetal death; 6) spontaneous abortion; and 7) others. A subset of patients had placenta bed biopsy. The incidence of acute atherosis was compared among the different groups. Results: 1) The prevalence of acute atherosis in uncomplicated pregnancies was 0.4% (29/6,961) based upon examination of nearly 7,000 placentas; 2) the frequency of acute atherosis was 10.2% (181/1,779) in preeclampsia, 9% (26/292) in fetal death, 2.5% (3/120) in midtrimester spontaneous abortion, 1.7% (22/1,298) in small for gestational age neonates, and 1.2% (23/1,841) in spontaneous preterm labor and PPROM; 3) among patients with preeclampsia, those with acute atherosis had significantly more severe disease, earlier onset, and a greater frequency of small for gestational age neonates (p < 0.05 all); 4) the lesion was more frequently observed in the decidua (parietalis or basalis) than in the decidual segment of the spiral arteries in patients with placental bed biopsies. Conclusions: Acute atherosis is rare in normal pregnancy, and occurs more frequently in patients with pregnancy complications, including preeclampsia, spontaneous preterm labor, preterm PROM, midtrimester spontaneous abortion, fetal death, and SGA.
    Preview · Article · Oct 2014 · Journal of Maternal-Fetal and Neonatal Medicine
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: Acute atherosis is a lesion of the spiral arteries characterized by fibrinoid necrosis of the vessel wall, an accumulation of fat-containing macrophages, and a mononuclear perivascular infiltrate, which can be found in patients with preeclampsia, fetal death, small-for-gestational age, spontaneous preterm labor/premature prelabor rupture of membrane, and spontaneous mid-trimester abortion. This lesion is thought to decrease blood flow to the intervillous space which may lead to other vascular lesions of the placenta. The objective of this study was to test whether there is an association between acute atherosis and placental lesions that are consistent with maternal vascular underperfusion, amniotic fluid infection, fetal vascular thrombo-occlusive disease or chronic inflammation. Material and methods: A retrospective cohort study of pregnant women who delivered between July 1998 and July 2014 at Hutzel Women's Hospital/Detroit Medical Center was conducted examine 16,457 placentas. The frequency of placenta lesions (diagnosed using the criteria of the Perinatal Section of the Society for Pediatric Pathology) was compared between pregnancies with and without acute atherosis. Results: Among 16,457 women who were enrolled, 10.2% (1,671/16,457) were excluded, leaving 14,786 women who contributed data for analysis. Among them, the prevalence of acute atherosis was 2.2% (326/14,786). Women with acute atherosis were more than six times as likely as those without to have placental lesions consistent with maternal underperfusion (adjusted odds ratio- aOR: 6.7; 95% CI 5.2-8.6). To a lesser degree, acute atherosis was also associated with greater risks of having either lesions consistent with fetal vascular thrombo-occlusive disease (aOR 1.7; 95% CI 1.2-2.3) or chronic chorioamnionitis (aOR 1.9; 95% CI 1.3-3), but not with other chronic inflammatory lesions, after adjusting for gestational age at delivery. In contrast, women with acute atherosis were 60% less likely to have lesions consistent with amniotic fluid infection, adjusting for gestational age at delivery (aOR 0.4; 95% CI 0.3-0.5). Conclusions: Acute atherosis is associated with increased risks of having placental lesions consistent with maternal vascular underperfusion, and to a lesser extent, chronic chorioamnionitis and those consistent with fetal vascular thrombo-occlusive disease.
    Preview · Article · Sep 2014 · Journal of Maternal-Fetal and Neonatal Medicine
  • Suzanne M Jacques · William J Kupsky · Faisal Qureshi
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: With advances in therapy, more neonates with severe congenital anomalies are surviving, albeit some with neurologic disorders, possibly related to antenatal low brain blood flow. This autopsy series reports antenatal brain injury in neonates expiring due to severe anomalies, and provides correlation with umbilical cord blood gas and acid-base analysis. Methods: We identified autopsies of 3(rd) trimester neonates expiring shortly following delivery due to severe anomalies or malformations. Brain injury classified as "older" included periventricular leukomalacia, gliosis, and karyorrhectic neurons, and "recent" included red neurons and reactive glial changes. Results: We identified 22 cases (9 term, 13 preterm). 16 (73%) had brain injury, including 11 with older injury. Cord arterial blood was analyzed in 17, and 6 had pH <7 or base deficit > 12 mmol/L. 4 of 5 (80%) neonates with neuronal necrosis compared to 2 of 12 (17%) without had a pH <7 or base deficit > 12 mmol/L (p=0.03). 5 of 9 (56%) neonates with white matter injury compared to 1 of 8 (13%) without had pH <7 or base deficit > 12 mmol/L (p=NS). Conclusions: Antenatal brain injury is frequent in neonates with severe congenital anomalies. Severely abnormal cord blood analysis results correlate significantly with neuronal necrosis and show a trend toward white matter injury; however, the absence of these abnormal results does not preclude the presence of brain injury.
    No preview · Article · Aug 2014 · Journal of Maternal-Fetal and Neonatal Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To examine the association between an umbilical artery notch and fetal deterioration in monochorionic/monoamniotic (MC/MA) twins. Methods: Six MC/MA twin pregnancies were admitted at 24-28 weeks of gestation for close fetal surveillance until elective delivery at 32 weeks or earlier in the presence of signs of fetal deterioration. Ultrasound (US) examinations were performed twice weekly. The presence of cord entanglement, umbilical artery notch, abnormal Doppler parameters, a non-reassuring fetal heart rate pattern, or an abnormal fetal biophysical profile were evaluated. Results: Umbilical cord entanglement was observed on US in all pregnancies. The presence of an umbilical artery notch was noted in four out of six pregnancies and in two of them an umbilical artery notch was seen in both twins. The umbilical artery pulsatility index was normal in all fetuses. Doppler parameters of the middle cerebral artery and ductus venosus, fetal biophysical profile and fetal heart rate monitoring remained normal until delivery in all pregnancies. All neonates experienced morbidity related to prematurity; however, all were discharged home in good condition. Conclusion: The presence of an umbilical artery notch and cord entanglement, without other signs of fetal deterioration, are not indicative of an adverse perinatal outcome.
    No preview · Article · Jul 2014 · Fetal Diagnosis and Therapy
  • [Show abstract] [Hide abstract]
    ABSTRACT: The lesion termed 'placental infarction hematoma' is associated with fetal death and adverse perinatal outcome. Such a lesion has been associated with a high risk of fetal death and abruption placentae. The fetal and placental hemodynamic changes associated with placental infarction hematoma have not been reported. This paper describes a case of early and severe growth restriction with preeclampsia, and progressive deterioration of the fetal and placental Doppler parameters in the presence of a placental infarction hematoma. © 2014 S. Karger AG, Basel.
    No preview · Article · May 2014 · Fetal Diagnosis and Therapy
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: Vitamin D deficiency remains prevalent among pregnant women despite the recommended prenatal multivitamin supplementation. Low serum levels of 25 OH D were associated with adverse pregnancy outcomes such as preeclampsia, gestational diabetes mellitus, and increased mother to child HIV transmission. The effect of vitamin D deficiency on placental inflammation in humans has not been examined. Objective: To examine the relationship between levels of vitamin D at birth and risk and /or severity of chorioamnionitis among VLBWI Methods: Serum levels of 25 OHD were determined the first day of life in a cohort of VLBWI (BW≤ 1250g) with respiratory distress. Maternal and fetal chorioamnionitis (MCA and FCA) were graded for severity (0-2) and staged (1-3) for extent (chronicity).Total 25OH vitamin D levels were determined using HPLC tandem mass spectrometry method. Infants were divided into 2 groups based on presence (chorio +) or absence (chorio -) of histological chorioamnionitis. Vitamin D status was categorized as sufficient (> 30ng/ml, insufficient (10-30 ng/ml) and deficient (< 10 ng/ml). Results : Infants in chorio + group (n=17) had similar BW but lower GA than infants in chorio - group (n=15) [mean (±SD): 754±183g vs 870±282, p=.171 and 25±1 vs 28±2 wks, respectively, p=.000). Mean(±SD) vitamin D levels among all infants was 13.93±8.11ng/ml. Fourteen out of 32 (41%) infants had vitamin D deficiency(< 10 ng/ml), and 59% of infants were vitamin D insufficient. Infants with chorioamnionitis had vitamin D levels similar to infants without chorioamnionitis (15.59±7.92 ng/ml vs 11.80±7.24 ng/ml, respectively, p=0.170). Logistic regression analysis failed to reveal an association between MCA or FCA and levels of vitamin D at birth (p=.102 and .441, respectively). Similarly, among infants with histological chorioamnionitis, there was no association between severity of MCA or FCA and vitamin D levels. Conclusion : All VLBWI had insufficient or deficient 25 OH D levels at birth. There was no stastistically significant association between levels of vitamin D on first day of life and presence and or severity of histological chorioaminionitis.
    No preview · Conference Paper · Oct 2013
  • Suzanne M Jacques · William J Kupsky · Faisal Qureshi
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: Third trimester fetal deaths occurring in the hospital at the time of delivery are unusual. We report an autopsy series of such cases with emphasis on neuropathological injury and other lesions predating delivery. Methods: We identified autopsies performed on third trimester fetuses documented to be alive shortly before delivery, but that expired during, or very close to, time of delivery, and we correlate autopsy and placental findings. Fetuses with major congenital anomalies were excluded. Results: 10 cases were identified (6 term, 4 preterm). All were delivered by cesarean-section and had attempted resuscitation. Established or recent brain injury was identified in 9 of 10 cases, including 3 with established neuronal damage and 1 with periventricular leukomalacia. Additional autopsy findings included thymic involution in 8 (5 mild; 3 severe), myocardial infarcts in 2; intrathoracic petechiae in 5, and ascites or pleural or pericardial effusions in 6. Severe thymic involution and myocardial infarcts correlated with established brain injury. Placental lesions adaptive to decreased oxygenation (increased nucleated red blood cells or villous hypervascularity) were seen in 5 cases and correlated with established brain injury. Acute chorioamnionitis with funisitis was present in 1, and chronic inflammatory placental lesions were present in 6. Conclusions: These findings indicate brain injury predated the time period immediately before delivery in 9 of 10 fetuses, and in the fetuses with established brain injury the onset of acute illness was possibly >72 hours before delivery.
    No preview · Article · Aug 2013 · The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

  • No preview · Article · May 2013 · Diagnostic Cytopathology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the "trophoblast islands of the chorionic connective tissue" (TICCT). This study was conducted to determine the clinical significance of TICCT. Methods: Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N = 2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24(+0) weeks to 41(+6) weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT. Results: The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16-1.45, p < 0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001) . Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18-0.31, p < 0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29-0.58, p < 0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28-2.11, p < 0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46-2.85, p < 0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45-0.81, p = 0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40-0.84, p = 0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44-0.81, p = 0.001). Conclusions: Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.
    No preview · Article · Feb 2013 · Placenta
  • Faisal Qureshi · Suzanne M Jacques

    No preview · Article · Dec 2012 · Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine
  • Suzanne M Jacques · Faisal Qureshi
    [Show abstract] [Hide abstract]
    ABSTRACT: A case of hemangioma of the umbilical cord with an associated amnionic epithelial inclusion cyst (4.5 cm in maximum dimension), diagnosed by pathological examination at 26 weeks of gestation following in utero fetal demise, is reported. These are both uncommon lesions of the umbilical cord, and to our knowledge, have not been reported together. Prenatal ultrasound at 20 weeks of gestation had shown no fetal or placental abnormalities. The cyst formation may have been secondary to the hemangioma, possibly the result of damage to the amnion caused by the associated edema and myxomatous degeneration of Wharton's jelly.
    No preview · Article · Sep 2012 · Fetal and pediatric pathology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract We report the neuropathologic findings and clinicopathologic associations in 63 third trimester singleton stillborn fetuses. All were {greater than or equal to}28 weeks (wks) estimated gestational age (EGA) with complete autopsies including placental examination. Fetuses with chromosomal abnormalities, major congenital anomalies, and intrapartum demise were excluded. The cases were divided into those with abruption (n=12) and those with unexplained fetal demise (n=51). The latter group was then subdivided by gestational age with three subgroups (preterm 28 to <32 weeks EGA (n=16), preterm 32 to <37 weeks EGA (n=13), and term 37-41 weeks EGA (n=22). Each group was further subdivided as appropriate-for-gestational age/large-for-gestational age (AGA/LGA) or small-for-gestational age (SGA). Placental lesions were also evaluated and correlated with brain lesions. Established or recent injury involving gray or white matter was seen in 88% of the fetuses with unexplained demise versus 42% with abruption (p=0.001). The most common form of brain injury was established gray matter damage, seen in 65% of the fetuses with unexplained demise versus 25% with abruption (p=0.021), the most common pattern being established pontosubicular neuronal necrosis plus established neuronal necrosis in other sites. There was no significant difference in the frequency of brain injury between the SGA fetuses and AGA/LGA fetuses or between the unexplained stillbirth preterm and term subgroups, and no unequivocal correlation between placental lesions and brain lesions. Brain injury, most frequently established gray matter damage, is seen in the majority of stillborn infants with unexplained demise, indicating that the brain injury predates the period immediately before the death.
    No preview · Article · Jul 2012 · Pediatric and Developmental Pathology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic chorioamnionitis is a histological manifestation of maternal anti-fetal cellular rejection. As failure of graft survival is the most catastrophic event in organ transplantation, we hypothesized that fetal death could be a consequence of maternal rejection. The aim of this study was to assess whether there is evidence of cellular and antibody-mediated rejection in fetal death. Placental histology was reviewed for the presence of chronic chorioamnionitis in unexplained preterm fetal death (n=30) and preterm live birth (n=103). Amniotic fluid CXCL10 concentrations were measured with a specific immunoassay. Chronic chorioamnionitis was more frequent in fetal death than in live birth (60.0% versus 37.9%; P<0.05) and fetal death had a higher median amniotic fluid CXCL10 concentration than live birth (2.0 versus 1.8 ng/ml, P<0.05), after adjusting for gestational age at amniocentesis. Maternal anti-human leucocyte antigen class II panel-reactive seropositivity determined by flow cytometry was higher in fetal death compared to live birth (35.7% versus 10.9%; P<0.05). Chronic chorioamnionitis is a common pathologic feature in unexplained preterm fetal death. This novel finding suggests that cellular and antibody-mediated anti-fetal rejection of the mother is associated with fetal death (graft failure) in human pregnancy.
    No preview · Article · Nov 2011 · Histopathology
  • Suzanne M Jacques · Faisal Qureshi

    No preview · Article · Jul 2011 · International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists

Publication Stats

2k Citations
288.65 Total Impact Points


  • 1988-2015
    • Wayne State University
      • • Department of Pathology
      • • Department of Obstetrics and Gynecology
      Detroit, Michigan, United States
  • 1996-2012
    • Detroit Medical Center
      • Division of Pathology
      Detroit, Michigan, United States
    • Harvard Medical School
      • Department of Pathology
      Boston, Massachusetts, United States
  • 2003-2011
    • Harper University Hospital
      Detroit, Michigan, United States
    • Karmanos Cancer Institute
      • Division of Hematology and Oncology
      Detroit, Michigan, United States
  • 2002
    • National Institute of Child Health and Human Development
      Maryland, United States
  • 2000
    • University of Adelaide
      • Discipline of Obstetrics and Gynaecology
      Tarndarnya, South Australia, Australia
  • 1997
    • University of Alabama at Birmingham
      • Department of Obstetrics and Gynecology
      Birmingham, Alabama, United States
  • 1995
    • Children's Hospital of Michigan
      Detroit, Michigan, United States
  • 1994
    • William Beaumont Army Medical Center
      El Paso, Texas, United States