Objective: To identify pathological placental differences between early- and late-onset preeclampsia, in terms of fetal growth restriction (FGR).

Study Design: The placentas of patients attending a tertiary medical center for preeclampsia were analyzed by a single pathologist for lesions consistent with maternal underperfusion or fetal thrombo-occlusive disease (vascular and villous changes). Findings were compared between patients who gave birth before 34 weeks (early-onset preeclamplsia) or later (late-onset preeclampsia).

Results: Compared to the late-onset group (n=93), the early-onset group (n=37) was characterized by significantly higher rates of FGR (62.2% vs. 25.8%, P<0.001) and placental villous lesions of maternal origin (78.4% vs. 51.6%, P =0.005). Within the early-onset group, patients with FGR had significantly more placental lesions of fetal origin than those without FGR (47.8% vs. 7%, P =0.01).

Conclusion: In early preeclamplsia, parallel pathological pathways exist in the fetal and maternal placental vascular compartments, as opposed to late-onset preeclampsia.

Authors:

Michal Kovo¹; Letizia Schreiber²; Avi Ben-Haroush³;
Eran Gold¹; Jacob Bar¹; Abraham Golan¹

Department of Obstetrics & Gynecology 1 and Department of Pathology 2, the Edith Wolfson Medical Center, Holon and the Department of Obstetrics & Gynecology Rabin Medical Center 3, Petah-Tikva; affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; Israel