Histopathological Changes in The Placentas of Pregnant Women with Premature Rupture of Membranes (PROM) and Preterm PROM
Abstract
Introduction: Premature rupture of membranes (prom) and preterm prom (pprom) are critical obstetric complications associated with placental dysfunction. Histological changes in PPROM placentas have not been studied much in studies compared to PROM. This study aimed to investigates histopathological alterations in placental tissues of premature rupture of membranes of PROM and preterm PROM patients .
Methods: This experimental non-randomized case-control study was conducted with 30 PROM patients , PPROM pregnant women and 30 healthy pregnant women at Dicle University Faculty of Medicine between May 2024 and May 2025. Placental tissues obtained following cesarean delivery were subjected to routine tissue monitoring. Placental samples were stained with hematoxylin-eosin and examined histopathologically using a light microscope.
Results: When histopathological findings were compared between the PROM, PPROM and control groups, villous integrity in control groups, congestion in blood vessels, fibrinoid accumulation, inflammation and intervillous hemorrhage were higher in the PPROM group than in the control group (p<0.001).H&E revealed preserved villous integrity in controls, partial atrophy/fibrin deposition in PROM, and severe degeneration/edema in preterm PROM.
Conclusion: Preterm PROM placentas display pronounced histopathological damage. The intricate relationship between PROM and placental pathology underscores the profound impact of metabolic changes on placental structure and function throughout pregnancy. Understanding these pathological changes is crucial for elucidating the progression of PPROM and its implications for maternal and fetal health, highlighting the importance of comprehensive placental analysis in managing pregnancies complicated by PROM.
Keywords: Placenta, Premature Rupture of Membranes, Preterm Premature Rupture of Membranes, Histopathology, Hematoxylin-Eosin Staining
Keywords:
Premature Rupture Of Membranes (Prom), Preterm Prom, Hematoxylin-Eosin Staining, Histopathological ExaminationDOI
https://doi.org/10.22270/jddt.v15i7.7267References
1. Lee T, Silver H. Etiology and epidemiology of preterm premature rupture of the membranes. Clin Perinatol. 2001;28:721-34. https://doi.org/10.1016/S0095-5108(03)00073-3 PMid:11817185
2. Gopalani S, Krohn M, Meyn L, et al. Contemporary management of preterm premature rupture of membranes: determinants of latency and neonatal outcome. Am J Perinatol. 2004;21:183-90. https://doi.org/10.1055/s-2004-828609 PMid:15168316
3. Garite TJ. Management of premature rupture of membranes. Clin Perinatol. 2001;28:837-47. https://doi.org/10.1016/S0095-5108(03)00081-2 PMid:11817193
4. Goldenberg RL, Hauth JC, Andrews WW. Intrauterine infection and preterm delivery. N Engl J Med. 2000;342:1500-7. https://doi.org/10.1056/NEJM200005183422007 PMid:10816189
5. Asrat T. Intra-amniotic infection in patients with preterm prelabor rupture of membranes. Pathophysiology, detection, and management. Clin Perinatol. 2001;28:735-51. PMid:11817186 https://doi.org/10.1016/S0095-5108(03)00074-5
6. Della Rosa, P. A., Miglioli, C., Caglioni, M., Tiberio, F., Mosser, K. H. H., Vignotto, E., Canini, M., Baldoli, C., Falini, A., Candiani, M., & Cavoretto, P. A hierarchical procedure to select intrauterine and extrauterine factors for methodological validation of preterm birth risk estimation. BMC pregnancy and childbirth, 2021;21(1):306. https://doi.org/10.1186/s12884-021-03654-3 PMid:33863296 PMCid:PMC8052693
7. Delorme, P., Lorthe, E., Sibiude, J., & Kayem, G. Preterm and term prelabour rupture of membranes: A review of timing and methods of labour induction. Best practice & research. Clinical obstetrics & gynaecology, 2021;77:27-41. https://doi.org/10.1016/j.bpobgyn.2021.08.009 PMid:34538740
8. Rani A, Wadhwani N, Chavan-Gautam P, Joshi S. Altered development and function of the placental regions in preeclampsia and its association with long-chain polyunsaturated fatty acids. Wiley Interdiscip Rev Dev Biol. 2016;5(5):582-97. https://doi.org/10.1002/wdev.238 PMid:27239793
9. Mess A, Carter AM. Evolution of the placenta during the early radiation of placental mammals. Comp Biochem Physiol A Mol Integr Physiol. 2007;148(4):769-79. https://doi.org/10.1016/j.cbpa.2007.01.029 PMid:17347003
10. Lobo SE, Leonel LC, Miranda CM, Coelho TM, Ferreira GA, Mess A, et al. The Placenta as an Organ and a Source of Stem Cells and Extracellular Matrix: A Review. Cells Tissues Organs. 2016;201(4):239-52. https://doi.org/10.1159/000443636 PMid:27050810
11. Turco MY, Moffett A. Development of the human placenta. Development. 2019;146(22):dev163428. https://doi.org/10.1242/dev.163428 PMid:31776138
12. Menon, R., & Fortunato, S. J. Infection and the role of inflammation in preterm premature rupture of the membranes. Best practice & research. Clinical obstetrics & gynaecology, 2007;21(3):467-478. https://doi.org/10.1016/j.bpobgyn.2007.01.008 PMid:17448730
13. Kim, C. J., Romero, R., Chaemsaithong, P., Chaiyasit, N., Yoon, B. H., & Kim, Y. M. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. American journal of obstetrics and gynecology, 2015;213(4 Suppl), S29-S52. https://doi.org/10.1016/j.ajog.2015.08.040 PMid:26428501 PMCid:PMC4774647
14. Gomez-Lopez, N., Romero, R., Galaz, J., Xu, Y., Panaitescu, B., Slutsky, R., Motomura, K., Gill, N., Para, R., Pacora, P., Jung, E., & Hsu, C. D. Cellular immune responses in amniotic fluid of women with preterm labor and intra-amniotic infection or intra-amniotic inflammation. American journal of reproductive immunology (New York, N.Y. : 1989;82(5):e13171. PMCid:PMC6788958 https://doi.org/10.1111/aji.13171 PMid:31323170
15. Redline, R. W. Placental pathology: a systematic approach. *Modern Pathology, 2008;21(3):214-221.
16. Romero, R., Espinoza, J., Mazor, M., Manaster, I., Kusanovic, J. P., & Diamond, M. P. The preterm parturition syndrome. *BJOG: An International Journal of Obstetrics & Gynaecology, 2006;113(s3):17-42. https://doi.org/10.1111/j.1471-0528.2006.01120.x PMid:17206962 PMCid:PMC7062298
17. Fortunato, S. J., & Menon, R. Preterm premature rupture of membranes: a cascade of events leading to fetal inflammation. *American Journal of Obstetrics and Gynecology, 2001;185(6 Suppl):S53-S63.
18. Mayhew, T. M., Ohadike, C. I., Baker, P. N., & Crocker, I. P. Stereological investigation of placental morphology in pregnancies complicated by pre-eclampsia with and without intrauterine growth restriction. *Placenta, 2000;21(2-3):143-153.
19. Benirschke, K., & Kaufmann, P. Pathology of the Human Placenta. Springer. 2000. https://doi.org/10.1007/978-1-4757-4199-5
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Copyright (c) 2025 Deniz Balsak , Fırat Aşır , Fatma Zehra Kurnuç, Elif Ağaçayak , Murat Akkuş
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