Placental pathology in fetuses with congenital heart disease and its association with hypoxia
Purpose To explore the placental pathological changes in fetuses with congenital heart disease(CHD)and the presence of hypoxia and mitochondrial-related protein abnormali-ties in CHD placenta.Methods Clinical data and placental tissues from 52 fetuses undergoing induction of labor for CHD were collected.Placental sections from the CHD group and con-trol group(fetuses with isolated cleft lip and palate without other malformations)were stained with routine HE staining for mor-phological observation under a microscope.Immunohistochemis-try with EnVision method was used to detect the expression of hypoxia-related factor HIF-1α and mitochondrial-related factors COX Ⅰ and COX Ⅳ in placental trophoblastic cells.Its clinical characteristics and placental pathological changes were also ana-lyzed.Results Approximately 84.6％(44/52)of the CHD group were accompanied by morphological changes,including stem villous inclusion bodies(38.5％,20/52),stem villous mesenchymal dysplasia(23.1％,12/52),and stem villous cal-cification(19.2％,10/52),chorioamnionitis(32.7％,17/52).Compared to the control group,the CHD group had a sta-tistically significant difference in the occurrence of villous inclu-sion bodies and chorioamnionitis(P＜0.05).Among the four CHD subgroups,the incidence of villous dysplasia was higher in the complex cardiac malformation subgroup(P＜0.05).Com-pared to the control group,the CHD group showed significantly increased expression of HIF-1α protein(P＜0.05)and de-creased expression of mitochondrial-related factors COX Ⅰ and COX Ⅳ(P＜0.05),with statistically significant differences.Conclusion There are some changes in placenta pathology in fetuses with CHD,including villous inclusion bodies,villous dysplasia,villous calcification,and chorioamnionitis.Placental hypoxia affects trophoblast mitochondrial function and ATP ener-gy supply,which may have certain effects on fetal cardiac devel-opment during the fetal-heart-placenta symbiotic stage.
万方数据
维普
