CLINICAL CORRELATIONS OF PATTERNS OF PLACENTAL PATHOLOGY IN PRETERM PREECLAMPSIA

The objective of this study was to determine if placental histopatholo gy patterns are associated with clinical features of preterm pre-eclam psia. A 1989-1993 database of consecutive non-anomalous singleton live births delivered at 22-32 weeks gestation excluding cases of maternal diabetes mellitus and chronic hypertension included 74 cases of pre-ec lampsia. Placentae were scored for uteroplacental vascular lesions and lesions of chronic inflammation and coagulation. Thirteen lesion patt erns identified by factor analysis were studied in relation to the cli nical features. Severe maternal proteinuria was related to placental c hronic inflammation, while lower maternal antepartum platelet counts w ere related to placental abruption and infarct. Lower birthweight perc entile and lighter placentae were related directly to uteroplacental v ascular lesions. Diagnosis of HELLP and coagulopathy were less common when chronic inflammation scores were high. Serologic studies related to autoimmunity and maternal blood pressures were unrelated to placent al histopathology factors. It is concluded that features of maternal a nd fetal compromise in preterm pre-eclampsia are related to placental histopathology patterns. (C) 1998 W. B. Saunders Company Ltd.