Placental pathology in systemic lupus erythematosus: A prospective study

被引:106
作者
Magid, MS
Kaplan, C
Sammaritano, LR
Peterson, M
Druzin, ML
Lockshin, MD
机构
[1] Cornell Univ, Med Ctr, New York Hosp,Hosp Special Surg, Dept Pathol, New York, NY 10021 USA
[2] Cornell Univ, Med Ctr, New York Hosp,Hosp Special Surg, Dept Obstet & Gynecol, New York, NY 10021 USA
[3] Cornell Univ, Med Ctr, New York Hosp,Hosp Special Surg, Div Rheumat Dis, New York, NY 10021 USA
[4] Cornell Univ, Med Ctr, New York Hosp,Hosp Special Surg, Dept Biomech & Biomat, New York, NY 10021 USA
[5] SUNY Stony Brook, Univ Hosp, Dept Pathol, Stony Brook, NY 11794 USA
关键词
placenta; systemic lupus erythematosus; anticardiolipin antibody; pregnancy;
D O I
10.1016/S0002-9378(98)70277-7
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVES: Systemic lupus erythematosus and antiphospholipid antibody, often identified in patients with systemic lupus erythematosus, are associated with poor pregnancy outcome. This study distinguishes between the effect of each of these factors on gestational outcome and placental pathologic conditions in pregnant patients with systemic lupus erythematosus. STUDY DESIGN: Thirty-seven pregnancies and 40 placentas from 33 women with systemic lupus erythematosus were studied prospectively. RESULTS: Systemic lupus erythematosus alone, but not systemic lupus erythematosus activity, was associated with increased spontaneous abortions, preterm gestations, and fetal growth restriction. Placental correlates were ischemic-hypoxic change, decidual vasculopathy, decidual and fetal thrombi, chronic villitis, and decreased placental weight. Extensive infarction and fetal death were important antiphospholipid antibody-related findings. CONCLUSIONS: Decidual vasculopathy/coagulopathy appears to mediate the antiphospholipid antibody-related and much of the systemic lupus erythematosus-related deleterious effect on the placenta and gestational outcome. The presence of antiphospholipid antibody largely, but not invariably, predicts fetal death. Antiphospholipid antibody-independent chronic villitis may represent a second mechanism of systemic lupus erythematosus-related change.
引用
收藏
页码:226 / 234
页数:9
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