Acute atherosis and diffuse lipid infiltration of the placental bed: A review of historical lipid studies.

Abstract:

:Based on a variety of tissue samples, including Caesarean hysterectomy specimens with the placenta in situ, a detailed map of uteroplacental vascular lesions was established in over a century of research. One such lesion is acute atherosis of unremodelled basal and uteroplacental arteries, defined by the presence of fibrinoid necrosis, subendothelial macrophage foam cells, and perivascular lymphocytic infiltration. Two studies conducted over 50 years ago used Oil Red O staining of frozen tissue sections to visualise lipid infiltration of placental bed vessels and document the presence of lipid-laden foam cells in acute atherosis. These studies also demonstrated that significant amounts of intracellular and extracellular lipids can accumulate in the decidua basalis, often extending into the superficial layer of the myometrium. This phenomenon, termed diffuse lipid infiltration (DLI), was found not only to be prevalent in hypertensive and preeclamptic pregnancies but also associated with postterm pregnancies. Despite being a potential pathognomonic sign of placental malfunction, DLI has been neglected in the context placental bed pathophysiology. To renew interest in this putative pathological feature, and stimulate mechanistic investigations, we review here the original and, to our knowledge, only lipid studies on frozen placental bed tissue sections.

journal_name

Placenta

journal_title

Placenta

authors

Brosens I,Brosens JJ,Muter J,Benagiano G

doi

10.1016/j.placenta.2020.06.012

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

36-41

eissn

0143-4004

issn

1532-3102

pii

S0143-4004(20)30180-6

journal_volume

97

pub_type

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