Placentas from women with pregnancy-associated venous insufficiency show villi damage with evidence of hypoxic cellular stress

Publication date: Available online 4 April 2018
Source:Human Pathology
Author(s): Natalio García-Honduvilla, Miguel A Ortega, Ángel Asúnsolo, María J Álvarez-Rocha, Beatriz Romero, Juan De León-Luis, Melchor Álvarez- Mon, Julia Buján
Lower extremity venous insufficiency (VI) is a complication of pregnancy. The potential association of this venous disease with structural damage of the placenta has not been described. We analyzed the pattern of histopathological lesions and the gene and protein expression of HIF1-α and apoptosis regulatory proteins. A prospective study was carried out on placenta samples from 43 women with pregnancy-associated VI and 24 age-matched pregnant healthy controls (HC). Women with VI showed a significant increase in the number of villi (150.77±42.55 VI versus 122.13±27.74 HC) and in syncytial knots compared to those found in placentas from HC (67.15±31.08 VI versus 42.49±17.36 HC), and an increase in the number of bridges (32.40±2.67 VI versus 22.73±2.37 HC) (P<.05). The mean number of syncytial nodes per villus is 1.37±0.90 in the VI group and 0.49±0.58 in the HC group (P<.001). Significant increases in the expression of Bax and Caspase-3 and 9 in the placentas from women with VI were observed compared to those found in HC. The expression of HIF-1α at both the mRNA and protein levels was also significantly increased in placentas from women with VI. Our study demonstrates that placentas from women with pregnancy-associated VI show structural remodeling, with an increase in the number of villi and syncytial knots and enhanced apoptotic cellular death. Interestingly, this placental damage is associated with an increased expression of hypoxia-triggered molecular pathways, such as HIF-1α.



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