Anat Cell Biol.  2012 Jun;45(2):86-91. 10.5115/acb.2012.45.2.86.

Vasculosyncytial membrane in relation to syncytial knots complicates the placenta in preeclampsia: a histomorphometrical study

• Sankar KD
• Bhanu PS
• Kiran S
• Ramakrishna BA
• Shanthi V

• KMID: 2005870
• DOI: http://doi.org/10.5115/acb.2012.45.2.86

Abstract

The vasculosyncytial membrane (VSM), primary site of fetomaternal exchange is formed when syncytiotrophoblast surrounds the terminal villi and make a close contact with capillaries. Some syncytiotrophoblast forms thin single layer of villous and some syncytial nuclei become piled up to form the syncytial knots (SKs). Undoubtedly there is a clear-cut inverse relation between villous VSM and fetal hypoxia. In preeclampsia (PE) the hypoxia injury disrupts the syncytial architecture which in turn initiates other complications of PE. Present study was designed to observe the morphological and histomorphometric features of 84 placentas from control and PE (42 each) collected from Department of Obstetrics and Gynecology. Neonatal weight and placental weight were reduced in PE than the controls but the feto-placental index did not differ. The SK density and VSM thickness was found to be increased and was statistically significant in PE cases. In relation to SKs, the VSM thickness was twofold increased than the controls and was statistically significant. The SKs in the present study were classified as type-1, 2a, 2b, and 3. Type 1 was found to be 62% in control and 47% in PE, type 2a and 2b were 38% in control and 37% in PE, and type 3 was in 8% of PE cases. All the parameters of present study reveal the adverse effects of PE influencing on both morphological and microscopical features of the placenta resulting in fetal hypoxia.

Keyword

Pre-eclampsia; Placenta; Vasculosyncytial membrane; Syncytial knot

MeSH Terms

Anoxia
Capillaries
Fetal Hypoxia
Gynecology
Membranes
Obstetrics
Placenta
Pre-Eclampsia
Trophoblasts

Figure

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  Fig. 1 Schematic diagram showing the different types of terminal villi with syncytial knots, the blood vessels are indicated by V.

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  Fig. 2 Photomicrograph showing hematoxylin and eosin staining of the terminal villus with focal aggregation of the syncytial knots with its classification and vasculosyncytial membrane (VSM) in relation to syncytial knots (SKs). (A) Represent the type 1 SKs accumulate to one side of the terminal villi. (B) Type 2a SKs occupying half the circumference of the terminal villi. Some of them are collected in two or three small groups, type 2b (C). (D) Representative of type 3 SKs covers 3/4th of the terminal villi. (E) Terminal villi showing the blood vessels are indicated by 'V' and VSM are by arrows. (F) Placental terminal villi showing the VSM with SKs (red line) and without SKs (black line). Scale bars=8 µm (A-D), 18 µm (E, F).

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