Verfügbarkeit: Pathology of the human placenta

Pathology of the human placenta:

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Bibliographische Detailangaben
Hauptverfasser:	Benirschke, Kurt 1924-2018 (VerfasserIn), Kaufmann, Peter 1942-2010 (VerfasserIn), Baergen, Rebecca N. (VerfasserIn)
Format:	Buch
Sprache:	English
Veröffentlicht:	New York, NY Springer 2006
Ausgabe:	5. ed.
Schlagworte:	Pathologie Plazentakrankheit Plazenta
Online-Zugang:	Inhaltsverzeichnis
Beschreibung:	XVIII, 968 S. zahlr. Ill. u. graph. Darst.
ISBN:	0387267387

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MARC


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245	1	0	\|a Pathology of the human placenta \|c Kurt Benirschke ; Peter Kaufmann ; Rebecca Baergen
250			\|a 5. ed.
264		1	\|a New York, NY \|b Springer \|c 2006
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Datensatz im Suchindex

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adam_text	Contents Preface v 1. Examination of the Placenta 1 Macroscopic Examination 1 Storage 1 Selection 2 Photography 2 Examination 2 Placentas of Multiple Births 7 Fixation 8 Special Procedures 10 References 11 2. Macroscopic Features of the Delivered Placenta 13 Fetal Surface 13 Maternal Surface 13 The Terms Fetal Placenta and Maternal Placenta 15 References 15 3. Microscopic Survey 16 Typical Histologic Features of the First Trimester Placenta 16 Typical Histologic Features of the Third Trimester Placenta 20 Immunohistochemical Markers 24 4. Placental Types 30 Placental Shapes 32 Types of Maternofetal Interdigitation 34 Maternofetal Barrier 35 Maternofetal Blood Flow Interrelations 37 Placental Types and Phylogeny 37 Human Placenta 38 References 40 ix x Contents 5. Early Development of the Human Placenta 42 Prelacunar Stage 42 Lacunar Stage 44 Early Villous Stages 46 References 48 6. Basic Structure of the Villous Trees 50 M. Castellucci and P. Kaufmann Syncytiotrophoblast 50 Syncytium or Multinucleated Giant Cells? 50 Syncytial Plasmalemmas and Microvilli 54 Syncytiotrophoblastic Cytoskeleton 55 Specialized Regions of the Villous Surface 55 Syncytiotrophoblast with Prevailing Rough Endoplasmic Reticulum 55 Syncytiotrophoblast with Prevailing Smooth Endoplasmic Reticulum 57 Vasculosyncytial Membranes 59 Syncytial Lamellae Covering Langhans Cells 61 Syncytial Knots, Sprouts, and Bridges 61 Transtrophoblastic Channels 64 Trophoblastic Blebbing 64 Villous Cytotrophoblast (Langhans Cells) 65 Cytotrophoblast Cell Types 66 Nematosomes 70 Endocrine Activities of the Villous Cytotrophoblast 70 Trophoblast Turnover and Syncytial Fusion 72 Quantitation of Trophoblast Turnover 72 Why Does Syncytiotrophoblast Survival Depend on Syncytial Fusion? 72 Trophoblastic Differentiation and Apoptosis Cascade 73 Molecular Mechanisms of Syncytial Fusion 76 Phosphatidylserine Flip as Fusion Signal 76 Junctional and Adhesion Molecules as Fusion Mediators 76 The ADAM Family of Fusogenic Proteins 76 Endogenous Retroviral Envelope Proteins of the HERV Family (Syncytins) and Their Receptors 77 Molecular Control of Syncytial Fusion 78 The Role of Oxygen and Cytokines in Trophoblast Proliferation and Fusion 79 The Impact of Trophoblast Turnover on Syncytiotrophoblast Specialization 81 Trophoblastic Basement Membrane 82 Connective Tissue 82 Mesenchymal Cells (V Cells) 82 Fibroblasts (VD Cells and VDA Cells) 83 Myofibroblasts (VDAG Cells and VDAGM Cells) 84 Matrix Components of the Villous Stroma 86 Hofbauer Cells (Villous Macrophages) 87 First Descriptions 87 Morphology 87 Occurrence and Distribution 90 Origin 90 Contents xi Immunologic Aspects 91 Other Free Connective Tissue Cells 93 Basic Structure of the Vessel Walls 93 Fetal Capillaries 94 Large Fetal Vessels 94 Vasomotor Control 96 Fibrinoid of the Villous Trees 96 Perivillous Fibrinoid 96 Intravillous Fibrinoid 98 References 99 7. Architecture of Normal Villous Trees 121 Classification of Villous Types 121 Stem Villi 121 Immature Intermediate Villi 126 Mature Intermediate Villi 128 Terminal Villi 129 Mesenchymal Villi 133 Immunohistochemistry of Villous Types 134 Differentiation and Maturation of Villous Types 137 Development of the Mesenchymal Villi 137 Development and Fate of Immature Intermediate Villi 138 Development of Stem Villi 138 Development of the Mature Intermediate Villi 140 Development of the Terminal Villi 140 Angioarchitecture of Villi 140 Vascular Arrangement in Immature Villi 140 Larger Vessels of Stem Villi 141 Paravascular Capillary Net of Stem Villi 141 Arrangement of Vessels in Mature Intermediate and Terminal Villi 143 Sinusoids of Terminal Villi 145 Fetoplacental Angiogenesis as the Driving Force for Villous Development 146 General Aspects of Placental Vasculogenesis and Angiogenesis 147 Vasculogenesis 1: Origin of Hemangiogenic Progenitor Cells (Days 15 to 21) 148 Vasculogenesis 2: Formation of Endothelial Tubes (Days 21 to 32) 148 Angiogenesis 1: Branching Angiogenesis (Day 32 to Week 25) .... 153 Angiogenesis 2: Formation of Stem Vessels and Regression of Capillaries in Stem Villi (Weeks 15 to 32) 153 Angiogenesis 3: Prevailing Nonbranching Angiogenesis (Week 25 to Term) 154 Oxygen and Oxygen-Controlled Growth Factors as Regulators of Villous and Vascular Development 155 The Special Role of Oxygen in the Placenta 155 Types of Hypoxia and Its Effects on Villous Development 155 Evidence for Oxygen-Controlled Fetoplacental Angiogenesis 157 Oxygen-Controlled Angiogenic Growth Factors 157 The Timing Mismatch Between Changes in Oxygenation and Morphologic Changes 158 Oxygen and Villous Trophoblast 159 Contents Oxygen and Villous Stroma 159 Oxygen and Intervillous Circulation 159 Hormones as Regulators of Villous Development 160 Intervillous Space as Related to the Villous Trees 160 Width of the Intervillous Space 161 Organization of Villous Trees 161 Histopathologic Importance of Inhomogeneity of Villous Trees 164 Fetomaternal Flow Interrelations 164 References 165 8. Characterization of the Developmental Stages 174 Stages of Development 174 Nucleated Red Blood Cells 185 References 189 9. Nonvillous Parts and Trophoblast Invasion 191 H. G. Frank and P. Kaufmann Extravillous Trophoblast 191 Historical Aspects and Nomenclature 191 Extravillous Trophoblast Is a Tissue of Its Own 193 Proliferation Patterns of Extravillous Trophoblast and the Invasive Pathway 194 Stages of Extravillous Trophoblast Differentiation Within the Invasive Pathway 196 One Stem Cell Origin for Villous Syncytiotrophoblast and the Extravillous Trophoblast? 200 Cytokines and Hormones Controlling Differentiation of Extravillous Trophoblast 201 Extracellular Matrix Secretion Along the Invasive Pathway 204 Extracellular Matrix Receptors (Integrins) 204 Other Cell Adhesion Molecules and Gap Junction Molecules 206 Proteinases, Activators, and Inhibitors Involved in Trophoblast Invasion 207 Nitric Oxide and Trophoblast Invasion 209 Major Basic Protein 209 Cell Surface Carbohydrates 211 MHC Class I Molecules 212 Normal Extravillous Trophoblast Cells Are Never Proliferative and Invasive at One Time 213 Oxygen-Mediated Regulation of the Invasive Pathway 214 Extracellular pH as Trigger of Trophoblast Invasion 215 Trophoblastic Mechanisms Limiting Trophoblast Invasion 215 Endocrine Activities of Extravillous Trophoblast 216 Does Extravillous Trophoblast Differ from One Nonvillous Part to the Other? 217 Decidua 217 Composition of Decidua 217 Endometrial Stromal Cells and Decidual Cells 218 Endocrine and Paracrine Aspects of Decidua 220 Functional Considerations of Decidualization 221 B Cells and T Cells . 222 Contents xiii Endometrial Large Granular Lymphocytes (Endometrial NK Cells and uNK Cells) 223 Macrophages 224 Glandular Residues 225 Decidual Extracellular Matrix 225 Fibrinoid 226 Definition and Historical Remarks 226 Types of Fibrinoid 227 Origin of Fibrinoids 230 Interactions Between Matrix-Type and Fibrin-Type Fibrinoid 231 Functions of Fibrinoid 231 Trophoblast Invasion as a Result of Deciduo-Trophoblastic Interactions 233 Calcification 236 Chorionic Plate 239 Development 239 Structure at Term 239 Amnion 239 Spongy Layer 240 Chorionic Mesoderm 241 Extravillous Cytotrophoblast 241 Langhans Fibrinoid Layer 242 Marginal Zone 243 Subchorial Closing Ring 243 Trabeculae 244 Marginal Sinus 244 Basal Plate 244 Trophoblastic Shell and Development of the Basal Plate 244 Layers of the Basal Plate at Term 246 Uteroplacental Vessels 249 Development 249 Number and Position of the Uteroplacental Vessels 251 Importance of Physiologic Changes of Uteroplacental Arteries .... 252 Stages of Physiologic Changes in Uteroplacental Arteries 252 Sites and Routes of Endovascular Trophoblast Invasion 254 Trophoblast-Endothelial Adhesion Mechanisms 255 The Role of Macrophages in the Control of Endovascular Trophoblast Invasion 256 Incompetent Trophoblast Invasion or Exaggerated Maternal Defense as Causes for Maladaptation of Uteroplacental Arteries 257 Structure of Uteroplacental Veins 258 Intramural Fibrinoid of Uteroplacental Arteries and Veins 260 Functional Aspects of Uteroplacental Vessels 260 Septa, Cell Islands, and Cell Columns 261 Septa 261 Cell Islands 264 Cell Columns 265 Pathology of Trophoblast Invasion 268 Placenta Accreta 268 Placenta Increta and Percreta 271 Uterine Rupture 273 Placenta in Ectopic (Tubal) Pregnancy 275 Placenta in Abdominal Pregnancy 276 Cysts and Breus Mole 277 xiv Contents Maternal Floor Infarction 281 Decidual Degeneration 284 References 287 10. Involution of Placental Site; Retained Placenta 313 Involution of the Placental Site 313 Subinvolution 316 Placental Polyps 316 Involution of a Remaining Placenta 319 References 319 11. Anatomy and Pathology of the Placental Membranes 321 Overview 321 Development 323 Amnion 326 Amnionic Epithelium: Different Cell Types or Cell Degeneration ... 327 Cytologic and Functional Aspects of the Amnionic Epithelium 327 Amnionic Fluid 330 Chromosomal Determinations 331 Cellular Metaplasia and Glycogen 331 Amnionic Mesoderm 333 A Medley of Themes 334 Clinical and Research Applications 334 Chorion Laeve 335 Intermediate (Spongy) Layer 335 Chorionic Mesoderm 335 Trophoblast Layer 336 Decidua 337 Tensile Properties of the Membranes 338 Pathology of the Membranes 338 Preterm Rupture of the Membranes 338 Cysts, Tumors, and Hemorrhage 340 Amniotic Fluid Embolism 342 Meconium 345 Gastroschisis 354 Epidermolysis Bullosa 354 Amnion Nodosum 355 Amnionic Bands 358 Extramembranous Pregnancy 364 References 366 12. Anatomy and Pathology of the Umbilical Cord 380 Development 380 Amnionic Epithelium 380 Wharton s Jelly 381 Structure of Umbilical Vessels 383 Innervation 384 Contractility of Umbilical Vessels 385 Hyrtl s Anastomosis, False Knots, and Hoboken Nodes 386 Allantois 388 Omphalomesenteric Duct 389 Spiral Turns of the Cord 392 Contents xv Length of the Cord 394 Abnormal Length, Nuchal Cord 395 Site of Cord Insertion 401 Furcate Cord Insertion 402 Velamentous Cord Insertion 403 Placental Surface Vessels 407 Nucleated Red Blood Cells (NRBCs) 410 Cysts and Edema 411 Single Umbilical Artery 413 Placental Transfusion 415 Knots 416 False Knots 418 Strictures 419 Rupture 420 Hematoma 421 Varices and Aneurysms 423 Thrombosis of the Umbilical Vessels 426 Thrombosis of the Placental Vascular Tree 428 Tumors of the Umbilical Cord 434 References 435 13. Placental Shape Aberrations 452 Site of Placental Attachment 452 Volumetric Growth 454 Abnormal Shapes ( Errors in Outline ) 454 Placenta Previa 457 Placenta Membranacea 462 Circumvallate Placenta (Extrachorial, Circummarginate Placentas) 464 References 468 14. Histopathologic Approach to Villous Alterations 473 How to Assess Villous Histopathology 473 Assessment of Villous Maturation 473 Placental Insufficiency 476 Examination of Fetal Stem Vessels 477 Examination of the Fetal Capillary Bed 477 Villous Architecture and Fibrinoid 478 Intervillous Space, Infarcts 479 Abruptio Placentae 480 Major Histopathologic Findings 480 Syncytiotrophoblast 480 Knotting of the Syncytiotrophoblast 480 Langhans Cells 482 Vasculosyncytial Membranes 482 Trophoblastic Basement Membrane 482 Perivillous Fibrinoid 482 Intravillous Fibrinoid 483 Villous Calcification 483 Stem Vessels 483 Nucleated Red Blood Cells 484 Villous Capillarization 484 Stromal Architecture and Stromal Fibrosis 485 xvi Contents Hofbauer Cells (Macrophages) 486 Inflammatory Changes 486 Villous Edema or Immaturity 486 References 488 15. Classification of Villous Maldevelopment 491 Three-Dimensional Interpretation of Two-Dimensional Sections 491 Syncytial Knotting: Artifact or Meaningful Pathologic Finding 491 Interpretation of Syncytial Knotting 491 Artificial Knotting as Related to Villous Shapes in Paraffin Sections 494 Conclusions Concerning Knotting 497 Classification of Villous Maldevelopment 497 Summarizing Diagram of Villous Maldevelopment 497 Villous Maturation Score 500 Cases of Villous Maldevelopment 502 Synchronous Villous Immaturity 502 Persisting Villous Immaturity and Rhesus Incompatibility 502 Normal Mature Placenta 504 Preterm Villous Maturation and Villous Hypermaturity 506 Prolonged Pregnancy 507 Placentas at High Altitude and Maternal Anemia (Preplacental Hypoxia) 508 Intrauterine Growth Restriction with Preserved End-Diastolic Umbilical Flow in the Third Trimester, with or Without Late-Onset Preeclampsia (Uteroplacental Hypoxia) 509 Intrauterine Growth Restriction Combined with Absent or Reverse End-Diastolic Umbilical Blood Flow in the Second Trimester, with or Without Early-Onset Preeclampsia (Postplacental Hypoxia) 511 Preeclampsia 512 HELLP Syndrome (Postplacental Hypoxia) 513 Maternal Diabetes Mellitus 515 References 516 16. Erythroblastosis Fetalis and Hydrops Fetalis 519 Erythroblastosis Fetalis 519 Placental Pathology in Erythroblastosis 520 Nonimmune Hydrops 526 a-Thalassemia 527 Fetal Hemorrhage 529 Fetal Tumors 530 Congenital Anomalies and Hydrops Fetalis 532 Congenital Heart Disease 533 Cardiac Arrhythmias 534 Nephrotic Syndrome 534 Parvovirus Anemia 535 Hydrops of Unknown Etiology 540 References 541 17. Transplacental Hemorrhage, Cell Transfer, Trauma 552 Transplacental Blood and Cell Transfer 552 Trauma 552 Contents xvii Placenta in Hemorrhage 558 Technique for Identification of Fetal Red Blood Cells 559 Significant Transplacental Hemorrhage 561 Fetal Consequences of Massive Hemorrhage Across the Placenta ... 563 Other Fetal Blood Elements Passing Through the Placenta 568 Mother-to-Fetus Transfer of Cells 569 References 569 18. Fetal Storage Disorders 577 References 582 19. Maternal Diseases Complicating Pregnancy: Diabetes, Tumors, Preeclampsia, Lupus Anticoagulant 584 Maternal Diseases 584 Hematologic Disorders 592 Endocrine Disorders 596 Diabetes Mellitus During Pregnancy 596 Maternal Neoplasms 600 Hypertensive Disorders 604 Preeclampsia 604 Animal Models 605 Placental Pathology of Preeclampsia 605 Decidual Arteriopathy 606 Infarcts 612 Abruptio Placentae 615 Fetal Effects of Abruptio Placentae 620 Other Placental Changes in Preeclampsia 620 Etiology of Toxemia, Pregnancy-Induced Hypertension, or Preeclampsia 623 Lupus Erythematosus and Lupus Anticoagulant 625 Lupus Erythematosus 625 Lupus Anticoagulant 630 References 634 20. Infectious Diseases 657 Chorioamnionitis 657 Macroscopic Appearance 657 Microscopic Appearance 660 General Considerations of Chorioamnionitis 674 Specific Microorganisms 676 Mycoplasma Hominis and Ureaplasma 687 Chlamydia Trachomatis and C Psittaci 689 Bacterial Vaginosis 690 Syphilis 690 Necrotizing Funisitis 694 Other Spirochetal Diseases 696 Fungus Infections 696 Virus Infections and Villitides 700 Cytomegalovirus Infection 700 Herpes Simplex Virus Infection 706 Varicella (Chickenpox) 709 Epstein-Barr Virus 710 xviii Contents Smallpox, Vaccinia, Alastrim, and Parvovirus B19 710 Enteroviruses 712 Influenza, Mumps, Rabies 712 Hepatitis 712 Rubella (German Measles) and Other Viral Infections 713 Rubeola (Measles) 714 Human Immunodeficiency Virus Infection 715 Toxoplasmosis 716 Kala-Azar 720 Chagas Disease 720 Babesiosis, Trichomoniasis, Rickettsia, and Ehrlichia 722 Malaria 722 Other Parasitic Infections 724 Villitis of Unknown Etiology 724 References 732 21. Abortion, Placentas of Trisomies, and Immunologic Considerations of Recurrent Reproductive Failure 762 Anatomic Findings 764 Summary of Placental Findings in Chromosomally Defined Abortions 768 Trisomies 768 Polyploidies 770 Monosomy X 772 Induced Abortions 772 Incomplete Abortion 777 Placenta in Chorionic Villus Sampling 778 Trisomic Placentas 781 Chemical Markers and Trisomy 782 Recurrent or Habitual Abortion 784 References 787 22. Molar Pregnancies 797 Hydatidiform Moles and Partial Moles 797 Hydatidiform Moles 797 Other Attributes 811 Therapy 815 Partial Hydatidiform Mole 817 References 825 23. Trophoblastic Neoplasms 837 Choriocarcinoma 837 Choriocarcinoma In Situ and Choriocarcinoma Coincident with Pregnancy 843 Chorangiocarcinoma 846 Exaggerated Placental Site: Placental Site Nodule, Placental Site Trophoblastic Tumor, and Epithelioid Trophoblastic Tumor 846 Ultrastructure of Trophoblastic Tumors 851 Antigenic Studies of Trophoblastic Tumors 851 Epidemiology of Choriocarcinoma 852 Endocrine Aspects of Gestational Trophoblastic Neoplasia 852 Contents xix Ectopic Choriocarcinomas; Tumors in Men 853 Therapy of Gestational Trophoblastic Neoplasia 854 Choriocarcinoma in Anamils 855 Choriocarcinoma in Cell Lines and Genetics 855 References 856 24. Benign Tumors and Chorangiosis 863 Angiomas 863 Other Benign Tumors 870 Chorangiosis and Chorangiomatosis 871 Mesenchymal Dysplasia and the Beckwith-Wiedemann Syndrome 873 References 873 25. Multiple Pregnancies 877 Zygosity 877 The Placenta in the Study of Zygosity 879 Causes and Incidence of Multiple Births 885 Third Type of Twin 890 Twinning Incidence 891 Superfetation and Superfecundation 893 Vascular Anatomy of Twin Placentas 893 Monoamnionic/Monochorionic Twin Placenta 902 Diamnionic/Monochorionic Twin Placenta 915 Diamnionic/Dichorionic Twin Placenta 917 Vanishing Twin Phenomenon 919 Fetus Papyraceus 923 Twin-to-Twin Transfusion Syndrome 928 Acardiac Twins 941 Conjoined Twins 950 Sacrococcygeal Teratoma and Epignathus 953 Congenital Anomalies 955 Cytogenetics and Heterokaryotypic Monozygotic Twins 956 Chimerism and Mosaicism 957 Whole-Body Chimerism 959 Triplets and Higher Multiple Births 960 Twins in Abortion and Ectopic Pregnancy 967 Morbidity and Mortality 968 Hormones in Twin Pregnancy 971 References 971 26. Legal Considerations 1001 Twinning Problems 1004 Inflammation 1005 The Green Placenta 1007 Vascular Abnormalities 1008 Umbilical Cord 1009 Placental Villous Color 1009 Other Types of Pathology 1010 References 1013 xx Contents 27. Glossary 1016 28. Normative Values and Tables 1019 Index 1027
adam_txt	Contents Preface v 1. Examination of the Placenta 1 Macroscopic Examination 1 Storage 1 Selection 2 Photography 2 Examination 2 Placentas of Multiple Births 7 Fixation 8 Special Procedures 10 References 11 2. Macroscopic Features of the Delivered Placenta 13 Fetal Surface 13 Maternal Surface 13 The Terms Fetal Placenta and Maternal Placenta 15 References 15 3. Microscopic Survey 16 Typical Histologic Features of the First Trimester Placenta 16 Typical Histologic Features of the Third Trimester Placenta 20 Immunohistochemical Markers 24 4. Placental Types 30 Placental Shapes 32 Types of Maternofetal Interdigitation 34 Maternofetal Barrier 35 Maternofetal Blood Flow Interrelations 37 Placental Types and Phylogeny 37 Human Placenta 38 References 40 ix x Contents 5. Early Development of the Human Placenta 42 Prelacunar Stage 42 Lacunar Stage 44 Early Villous Stages 46 References 48 6. Basic Structure of the Villous Trees 50 M. Castellucci and P. Kaufmann Syncytiotrophoblast 50 Syncytium or Multinucleated Giant Cells? 50 Syncytial Plasmalemmas and Microvilli 54 Syncytiotrophoblastic Cytoskeleton 55 Specialized Regions of the Villous Surface 55 Syncytiotrophoblast with Prevailing Rough Endoplasmic Reticulum 55 Syncytiotrophoblast with Prevailing Smooth Endoplasmic Reticulum 57 Vasculosyncytial Membranes 59 Syncytial Lamellae Covering Langhans' Cells 61 Syncytial Knots, Sprouts, and Bridges 61 Transtrophoblastic Channels 64 Trophoblastic Blebbing 64 Villous Cytotrophoblast (Langhans' Cells) 65 Cytotrophoblast Cell Types 66 Nematosomes 70 Endocrine Activities of the Villous Cytotrophoblast 70 Trophoblast Turnover and Syncytial Fusion 72 Quantitation of Trophoblast Turnover 72 Why Does Syncytiotrophoblast Survival Depend on Syncytial Fusion? 72 Trophoblastic Differentiation and Apoptosis Cascade 73 Molecular Mechanisms of Syncytial Fusion 76 Phosphatidylserine Flip as Fusion Signal 76 Junctional and Adhesion Molecules as Fusion Mediators 76 The ADAM Family of Fusogenic Proteins 76 Endogenous Retroviral Envelope Proteins of the HERV Family (Syncytins) and Their Receptors 77 Molecular Control of Syncytial Fusion 78 The Role of Oxygen and Cytokines in Trophoblast Proliferation and Fusion 79 The Impact of Trophoblast Turnover on Syncytiotrophoblast Specialization 81 Trophoblastic Basement Membrane 82 Connective Tissue 82 Mesenchymal Cells (V Cells) 82 Fibroblasts (VD Cells and VDA Cells) 83 Myofibroblasts (VDAG Cells and VDAGM Cells) 84 Matrix Components of the Villous Stroma 86 Hofbauer Cells (Villous Macrophages) 87 First Descriptions 87 Morphology 87 Occurrence and Distribution 90 Origin 90 Contents xi Immunologic Aspects 91 Other Free Connective Tissue Cells 93 Basic Structure of the Vessel Walls 93 Fetal Capillaries 94 Large Fetal Vessels 94 Vasomotor Control 96 Fibrinoid of the Villous Trees 96 Perivillous Fibrinoid 96 Intravillous Fibrinoid 98 References 99 7. Architecture of Normal Villous Trees 121 Classification of Villous Types 121 Stem Villi 121 Immature Intermediate Villi 126 Mature Intermediate Villi 128 Terminal Villi 129 Mesenchymal Villi 133 Immunohistochemistry of Villous Types 134 Differentiation and Maturation of Villous Types 137 Development of the Mesenchymal Villi 137 Development and Fate of Immature Intermediate Villi 138 Development of Stem Villi 138 Development of the Mature Intermediate Villi 140 Development of the Terminal Villi 140 Angioarchitecture of Villi 140 Vascular Arrangement in Immature Villi 140 Larger Vessels of Stem Villi 141 Paravascular Capillary Net of Stem Villi 141 Arrangement of Vessels in Mature Intermediate and Terminal Villi 143 Sinusoids of Terminal Villi 145 Fetoplacental Angiogenesis as the Driving Force for Villous Development 146 General Aspects of Placental Vasculogenesis and Angiogenesis 147 Vasculogenesis 1: Origin of Hemangiogenic Progenitor Cells (Days 15 to 21) 148 Vasculogenesis 2: Formation of Endothelial Tubes (Days 21 to 32) 148 Angiogenesis 1: Branching Angiogenesis (Day 32 to Week 25) . 153 Angiogenesis 2: Formation of Stem Vessels and Regression of Capillaries in Stem Villi (Weeks 15 to 32) 153 Angiogenesis 3: Prevailing Nonbranching Angiogenesis (Week 25 to Term) 154 Oxygen and Oxygen-Controlled Growth Factors as Regulators of Villous and Vascular Development 155 The Special Role of Oxygen in the Placenta 155 Types of Hypoxia and Its Effects on Villous Development 155 Evidence for Oxygen-Controlled Fetoplacental Angiogenesis 157 Oxygen-Controlled Angiogenic Growth Factors 157 The Timing Mismatch Between Changes in Oxygenation and Morphologic Changes 158 Oxygen and Villous Trophoblast 159 Contents Oxygen and Villous Stroma 159 Oxygen and Intervillous Circulation 159 Hormones as Regulators of Villous Development 160 Intervillous Space as Related to the Villous Trees 160 Width of the Intervillous Space 161 Organization of Villous Trees 161 Histopathologic Importance of Inhomogeneity of Villous Trees 164 Fetomaternal Flow Interrelations 164 References 165 8. Characterization of the Developmental Stages 174 Stages of Development 174 Nucleated Red Blood Cells 185 References 189 9. Nonvillous Parts and Trophoblast Invasion 191 H. G. Frank and P. Kaufmann Extravillous Trophoblast 191 Historical Aspects and Nomenclature 191 Extravillous Trophoblast Is a Tissue of Its Own 193 Proliferation Patterns of Extravillous Trophoblast and the Invasive Pathway 194 Stages of Extravillous Trophoblast Differentiation Within the Invasive Pathway 196 One Stem Cell Origin for Villous Syncytiotrophoblast and the Extravillous Trophoblast? 200 Cytokines and Hormones Controlling Differentiation of Extravillous Trophoblast 201 Extracellular Matrix Secretion Along the Invasive Pathway 204 Extracellular Matrix Receptors (Integrins) 204 Other Cell Adhesion Molecules and Gap Junction Molecules 206 Proteinases, Activators, and Inhibitors Involved in Trophoblast Invasion 207 Nitric Oxide and Trophoblast Invasion 209 Major Basic Protein 209 Cell Surface Carbohydrates 211 MHC Class I Molecules 212 Normal Extravillous Trophoblast Cells Are Never Proliferative and Invasive at One Time 213 Oxygen-Mediated Regulation of the Invasive Pathway 214 Extracellular pH as Trigger of Trophoblast Invasion 215 Trophoblastic Mechanisms Limiting Trophoblast Invasion 215 Endocrine Activities of Extravillous Trophoblast 216 Does Extravillous Trophoblast Differ from One Nonvillous Part to the Other? 217 Decidua 217 Composition of Decidua 217 Endometrial Stromal Cells and Decidual Cells 218 Endocrine and Paracrine Aspects of Decidua 220 Functional Considerations of Decidualization 221 B Cells and T Cells '. ' 222 Contents xiii Endometrial Large Granular Lymphocytes (Endometrial NK Cells and uNK Cells) 223 Macrophages 224 Glandular Residues 225 Decidual Extracellular Matrix 225 Fibrinoid 226 Definition and Historical Remarks 226 Types of Fibrinoid 227 Origin of Fibrinoids 230 Interactions Between Matrix-Type and Fibrin-Type Fibrinoid 231 Functions of Fibrinoid 231 Trophoblast Invasion as a Result of Deciduo-Trophoblastic Interactions 233 Calcification 236 Chorionic Plate 239 Development 239 Structure at Term 239 Amnion 239 Spongy Layer 240 Chorionic Mesoderm 241 Extravillous Cytotrophoblast 241 Langhans' Fibrinoid Layer 242 Marginal Zone 243 Subchorial Closing Ring 243 Trabeculae 244 Marginal Sinus 244 Basal Plate 244 Trophoblastic Shell and Development of the Basal Plate 244 Layers of the Basal Plate at Term 246 Uteroplacental Vessels 249 Development 249 Number and Position of the Uteroplacental Vessels 251 Importance of Physiologic Changes of Uteroplacental Arteries . 252 Stages of Physiologic Changes in Uteroplacental Arteries 252 Sites and Routes of Endovascular Trophoblast Invasion 254 Trophoblast-Endothelial Adhesion Mechanisms 255 The Role of Macrophages in the Control of Endovascular Trophoblast Invasion 256 Incompetent Trophoblast Invasion or Exaggerated Maternal Defense as Causes for Maladaptation of Uteroplacental Arteries 257 Structure of Uteroplacental Veins 258 Intramural Fibrinoid of Uteroplacental Arteries and Veins 260 Functional Aspects of Uteroplacental Vessels 260 Septa, Cell Islands, and Cell Columns 261 Septa 261 Cell Islands 264 Cell Columns 265 Pathology of Trophoblast Invasion 268 Placenta Accreta 268 Placenta Increta and Percreta 271 Uterine Rupture 273 Placenta in Ectopic (Tubal) Pregnancy 275 Placenta in Abdominal Pregnancy 276 Cysts and Breus' Mole 277 xiv Contents Maternal Floor Infarction 281 Decidual Degeneration 284 References 287 10. Involution of Placental Site; Retained Placenta 313 Involution of the Placental Site 313 Subinvolution 316 Placental Polyps 316 Involution of a Remaining Placenta 319 References 319 11. Anatomy and Pathology of the Placental Membranes 321 Overview 321 Development 323 Amnion 326 Amnionic Epithelium: Different Cell Types or Cell Degeneration . 327 Cytologic and Functional Aspects of the Amnionic Epithelium 327 Amnionic Fluid 330 Chromosomal Determinations 331 Cellular Metaplasia and Glycogen 331 Amnionic Mesoderm 333 A Medley of Themes 334 Clinical and Research Applications 334 Chorion Laeve 335 Intermediate (Spongy) Layer 335 Chorionic Mesoderm 335 Trophoblast Layer 336 Decidua 337 Tensile Properties of the Membranes 338 Pathology of the Membranes 338 Preterm Rupture of the Membranes 338 Cysts, Tumors, and Hemorrhage 340 Amniotic Fluid Embolism 342 Meconium 345 Gastroschisis 354 Epidermolysis Bullosa 354 Amnion Nodosum 355 Amnionic Bands 358 Extramembranous Pregnancy 364 References 366 12. Anatomy and Pathology of the Umbilical Cord 380 Development 380 Amnionic Epithelium 380 Wharton's Jelly 381 Structure of Umbilical Vessels 383 Innervation 384 Contractility of Umbilical Vessels 385 Hyrtl's Anastomosis, False Knots, and Hoboken Nodes 386 Allantois 388 Omphalomesenteric Duct 389 Spiral Turns of the Cord 392 Contents xv Length of the Cord 394 Abnormal Length, Nuchal Cord 395 Site of Cord Insertion 401 Furcate Cord Insertion 402 Velamentous Cord Insertion 403 Placental Surface Vessels 407 Nucleated Red Blood Cells (NRBCs) 410 Cysts and Edema 411 Single Umbilical Artery 413 Placental Transfusion 415 Knots 416 False Knots 418 Strictures 419 Rupture 420 Hematoma 421 Varices and Aneurysms 423 Thrombosis of the Umbilical Vessels 426 Thrombosis of the Placental Vascular Tree 428 Tumors of the Umbilical Cord 434 References 435 13. Placental Shape Aberrations 452 Site of Placental Attachment 452 Volumetric Growth 454 Abnormal Shapes ("Errors in Outline") 454 Placenta Previa 457 Placenta Membranacea 462 Circumvallate Placenta (Extrachorial, Circummarginate Placentas) 464 References 468 14. Histopathologic Approach to Villous Alterations 473 How to Assess Villous Histopathology 473 Assessment of Villous Maturation 473 Placental Insufficiency 476 Examination of Fetal Stem Vessels 477 Examination of the Fetal Capillary Bed 477 Villous Architecture and Fibrinoid 478 Intervillous Space, Infarcts 479 Abruptio Placentae 480 Major Histopathologic Findings 480 Syncytiotrophoblast 480 Knotting of the Syncytiotrophoblast 480 Langhans' Cells 482 Vasculosyncytial Membranes 482 Trophoblastic Basement Membrane 482 Perivillous Fibrinoid 482 Intravillous Fibrinoid 483 Villous Calcification 483 Stem Vessels 483 Nucleated Red Blood Cells 484 Villous Capillarization 484 Stromal Architecture and Stromal Fibrosis 485 xvi Contents Hofbauer Cells (Macrophages) 486 Inflammatory Changes 486 Villous Edema or Immaturity 486 References 488 15. Classification of Villous Maldevelopment 491 Three-Dimensional Interpretation of Two-Dimensional Sections 491 Syncytial Knotting: Artifact or Meaningful Pathologic Finding 491 Interpretation of Syncytial Knotting 491 Artificial Knotting as Related to Villous Shapes in Paraffin Sections 494 Conclusions Concerning Knotting 497 Classification of Villous Maldevelopment 497 Summarizing Diagram of Villous Maldevelopment 497 Villous Maturation Score 500 Cases of Villous Maldevelopment 502 Synchronous Villous Immaturity 502 Persisting Villous Immaturity and Rhesus Incompatibility 502 Normal Mature Placenta 504 Preterm Villous Maturation and Villous Hypermaturity 506 Prolonged Pregnancy 507 Placentas at High Altitude and Maternal Anemia (Preplacental Hypoxia) 508 Intrauterine Growth Restriction with Preserved End-Diastolic Umbilical Flow in the Third Trimester, with or Without Late-Onset Preeclampsia (Uteroplacental Hypoxia) 509 Intrauterine Growth Restriction Combined with Absent or Reverse End-Diastolic Umbilical Blood Flow in the Second Trimester, with or Without Early-Onset Preeclampsia (Postplacental Hypoxia) 511 Preeclampsia 512 HELLP Syndrome (Postplacental Hypoxia) 513 Maternal Diabetes Mellitus 515 References 516 16. Erythroblastosis Fetalis and Hydrops Fetalis 519 Erythroblastosis Fetalis 519 Placental Pathology in Erythroblastosis 520 Nonimmune Hydrops 526 a-Thalassemia 527 Fetal Hemorrhage 529 Fetal Tumors 530 Congenital Anomalies and Hydrops Fetalis 532 Congenital Heart Disease 533 Cardiac Arrhythmias 534 Nephrotic Syndrome 534 Parvovirus Anemia 535 Hydrops of Unknown Etiology 540 References 541 17. Transplacental Hemorrhage, Cell Transfer, Trauma 552 Transplacental Blood and Cell Transfer 552 Trauma 552 Contents xvii Placenta in Hemorrhage 558 Technique for Identification of Fetal Red Blood Cells 559 Significant Transplacental Hemorrhage 561 Fetal Consequences of Massive Hemorrhage Across the Placenta . 563 Other Fetal Blood Elements Passing Through the Placenta 568 Mother-to-Fetus Transfer of Cells 569 References 569 18. Fetal Storage Disorders 577 References 582 19. Maternal Diseases Complicating Pregnancy: Diabetes, Tumors, Preeclampsia, Lupus Anticoagulant 584 Maternal Diseases 584 Hematologic Disorders 592 Endocrine Disorders 596 Diabetes Mellitus During Pregnancy 596 Maternal Neoplasms 600 Hypertensive Disorders 604 Preeclampsia 604 Animal Models 605 Placental Pathology of Preeclampsia 605 Decidual Arteriopathy 606 Infarcts 612 Abruptio Placentae 615 Fetal Effects of Abruptio Placentae 620 Other Placental Changes in Preeclampsia 620 Etiology of Toxemia, Pregnancy-Induced Hypertension, or Preeclampsia 623 Lupus Erythematosus and Lupus Anticoagulant 625 Lupus Erythematosus 625 Lupus Anticoagulant 630 References 634 20. Infectious Diseases 657 Chorioamnionitis 657 Macroscopic Appearance 657 Microscopic Appearance 660 General Considerations of Chorioamnionitis 674 Specific Microorganisms 676 Mycoplasma Hominis and Ureaplasma 687 Chlamydia Trachomatis and C Psittaci 689 Bacterial Vaginosis 690 Syphilis 690 Necrotizing Funisitis 694 Other Spirochetal Diseases 696 Fungus Infections 696 Virus Infections and Villitides 700 Cytomegalovirus Infection 700 Herpes Simplex Virus Infection 706 Varicella (Chickenpox) 709 Epstein-Barr Virus 710 xviii Contents Smallpox, Vaccinia, Alastrim, and Parvovirus B19 710 Enteroviruses 712 Influenza, Mumps, Rabies 712 Hepatitis 712 Rubella (German Measles) and Other Viral Infections 713 Rubeola (Measles) 714 Human Immunodeficiency Virus Infection 715 Toxoplasmosis 716 Kala-Azar 720 Chagas' Disease 720 Babesiosis, Trichomoniasis, Rickettsia, and Ehrlichia 722 Malaria 722 Other Parasitic Infections 724 Villitis of Unknown Etiology 724 References 732 21. Abortion, Placentas of Trisomies, and Immunologic Considerations of Recurrent Reproductive Failure 762 Anatomic Findings 764 Summary of Placental Findings in Chromosomally Defined Abortions 768 Trisomies 768 Polyploidies 770 Monosomy X 772 Induced Abortions 772 Incomplete Abortion 777 Placenta in Chorionic Villus Sampling 778 Trisomic Placentas 781 Chemical Markers and Trisomy 782 Recurrent or Habitual Abortion 784 References 787 22. Molar Pregnancies 797 Hydatidiform Moles and Partial Moles 797 Hydatidiform Moles 797 Other Attributes 811 Therapy 815 Partial Hydatidiform Mole 817 References 825 23. Trophoblastic Neoplasms 837 Choriocarcinoma 837 Choriocarcinoma In Situ and Choriocarcinoma Coincident with Pregnancy 843 Chorangiocarcinoma 846 Exaggerated Placental Site: Placental Site Nodule, Placental Site Trophoblastic Tumor, and Epithelioid Trophoblastic Tumor 846 Ultrastructure of Trophoblastic Tumors 851 Antigenic Studies of Trophoblastic Tumors 851 Epidemiology of Choriocarcinoma 852 Endocrine Aspects of Gestational Trophoblastic Neoplasia 852 Contents xix Ectopic Choriocarcinomas; Tumors in Men 853 Therapy of Gestational Trophoblastic Neoplasia 854 Choriocarcinoma in Anamils 855 Choriocarcinoma in Cell Lines and Genetics 855 References 856 24. Benign Tumors and Chorangiosis 863 Angiomas 863 Other Benign Tumors 870 Chorangiosis and Chorangiomatosis 871 Mesenchymal Dysplasia and the Beckwith-Wiedemann Syndrome 873 References 873 25. Multiple Pregnancies 877 Zygosity 877 The Placenta in the Study of Zygosity 879 Causes and Incidence of Multiple Births 885 Third Type of Twin 890 Twinning Incidence 891 Superfetation and Superfecundation 893 Vascular Anatomy of Twin Placentas 893 Monoamnionic/Monochorionic Twin Placenta 902 Diamnionic/Monochorionic Twin Placenta 915 Diamnionic/Dichorionic Twin Placenta 917 Vanishing Twin Phenomenon 919 Fetus Papyraceus 923 Twin-to-Twin Transfusion Syndrome 928 Acardiac Twins 941 Conjoined Twins 950 Sacrococcygeal Teratoma and Epignathus 953 Congenital Anomalies 955 Cytogenetics and Heterokaryotypic Monozygotic Twins 956 Chimerism and Mosaicism 957 Whole-Body Chimerism 959 Triplets and Higher Multiple Births 960 Twins in Abortion and Ectopic Pregnancy 967 Morbidity and Mortality 968 Hormones in Twin Pregnancy 971 References 971 26. Legal Considerations 1001 Twinning Problems 1004 Inflammation 1005 The Green Placenta 1007 Vascular Abnormalities 1008 Umbilical Cord 1009 Placental Villous Color 1009 Other Types of Pathology 1010 References 1013 xx Contents 27. Glossary 1016 28. Normative Values and Tables 1019 Index 1027
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spellingShingle	Benirschke, Kurt 1924-2018 Kaufmann, Peter 1942-2010 Baergen, Rebecca N. Pathology of the human placenta Pathologie (DE-588)4044893-9 gnd Plazentakrankheit (DE-588)4221373-3 gnd Plazenta (DE-588)4174904-2 gnd
subject_GND	(DE-588)4044893-9 (DE-588)4221373-3 (DE-588)4174904-2
title	Pathology of the human placenta
title_auth	Pathology of the human placenta
title_exact_search	Pathology of the human placenta
title_exact_search_txtP	Pathology of the human placenta
title_full	Pathology of the human placenta Kurt Benirschke ; Peter Kaufmann ; Rebecca Baergen
title_fullStr	Pathology of the human placenta Kurt Benirschke ; Peter Kaufmann ; Rebecca Baergen
title_full_unstemmed	Pathology of the human placenta Kurt Benirschke ; Peter Kaufmann ; Rebecca Baergen
title_short	Pathology of the human placenta
title_sort	pathology of the human placenta
topic	Pathologie (DE-588)4044893-9 gnd Plazentakrankheit (DE-588)4221373-3 gnd Plazenta (DE-588)4174904-2 gnd
topic_facet	Pathologie Plazentakrankheit Plazenta
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