Histological features of uteroplacental vessels in normal and hypertensive patients in relation to birthweight

Article Abstract:

The placenta, the oval spongy structure in the uterus that is responsible for fetal nutrition, changes throughout pregnancy. The vast network of spiral arteries determine the large increase in blood flow during pregnancy. The resistance of blood flow caused by narrowing of blood vessels (vascular resistance) is low in the placenta vascular bed. The vascular changes that take place during a normal pregnancy, are compromised in patients with preeclampsia, a complication of pregnancy marked by high blood pressure, swelling, and protein in the urine; the chronic high blood pressure and can result in fetal growth retardation. Microscopic evaluation of blood vessels supplying the placenta in normal and in complicated pregnancies were studied immediately after delivery. Normal development results in spiral arteries extending from the decidua (the layer of tissue lining the uterus and encapsulating the implanted embryo to the myometrium) to the muscle layer. Three types of changes were studied: normal physiologic changes in both the decidua and the myometrium; changes restricted to the decidua alone; and the presence of atherosis, the narrowing of blood vessels caused by blood vessel wall damage. Of the 14 biopsies taken from women with normal pregnancies, 13 showed normal vascular changes in the decidua and myometrium. Of the 24 biopsies taken from women with complicated pregnancies, 18 showed atherosis, and six showed changes limited to the decidua alone; none had normal physiological changes in the decidua and myometrium. The five samples taken from patients with chronic high blood pressure had all three types of changes. Lower birth weights were found among patients with placentas with evidence of atherosis. It is thought that these abnormal changes increase the vascular resistance inside placental blood vessels, contributing to fetal growth retardation and preeclampsia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Maternal-fetal exchange, Complications and side effects, Fetus, Development and progression, Fetal growth retardation, Preeclampsia, Placenta, Hypertension in pregnancy, Gestational hypertension

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Life events and low birthweight - analysis by infants preterm and small for gestational age

Article Abstract:

The most important factor associated with infant morbidity and mortality is low birthweight. Previous studies indicating that social factors, such as stress, may influence birthweight have been considered inadequate because of the small number of cases examined, and because they did not take into account other influential factors such as cigarette smoking, maternal age and height, and number of previous births. In an attempt to clarify whether stressful life events can affect the birthweight of a newborn infant, social stress was evaluated in 92 women with low birthweight babies and in 92 women with normal weight babies. The Life Events and Difficulties Schedule (LEDS) was used to assess the 12 months prior to delivery. Demographic factors, smoking, and drinking were taken into account when the life events were compared with birthweights. The low birthweight group (less than 5.5 pounds) was divided into three groups called preterm (delivered before 37 weeks of gestation, with low birthweight but normal weight for their age); small for gestational age (SGA - low birthweight, delivered after 37 weeks of gestation); and preterm babies with SGA. Factors associated with low birthweight in the preterm group were severe life events or difficulties, previous low-weight births, and bleeding during pregnancy. For the SGA group, associated factors included low social support, cigarette smoking, and previous low-weight births. There was no relationship between birthweight and maternal age, height, marital status, social class, ethnic background, or sex of the baby. It has been suggested that social stress may cause low birthweight by reducing the caloric intake of the mother, thereby reducing the amount of weight gained by the mother during pregnancy. Social support may reduce the effects of stress on the mother and increase the birthweight of the baby. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Pregnancy, Life change events

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The epithelial changes associated with squamous cell carcinoma of the vulva: a review of the clinical, histological and viral findings in 78 women

Article Abstract:

Squamous cell carcinoma of the vulva is a malignancy of the squamous cells, which are flat, scaly, epithelial cells, lining the vulva (a portion of the female external genital tissue). This cancer is rare, and occurs most often in women 60 years of age and older. If the cancer is detected when the lesion is one millimeter or less in depth, the prognosis is excellent. Hence, abnormalities of the epithelial (outer tissue layer) of the vulva, which may indicate the early development of cancer, should be diagnosed and treated promptly. A classification system was developed to identify two conditions, vulvar intraepithelial neoplasia (VIN) and lichen sclerosus (a chronic anogenital eruption characterized by itching). This knowledge may help to define conditions that may be associated with a risk of cancer. Clinical characteristics, abnormal tissue microscopic features, and viral aspects of the skin adjacent to the abnormal lesion were assessed in 78 surgically removed specimens of squamous cell carcinoma of the vulva. Lichen sclerosus was found in 61 percent of the samples, whereas VIN was detected in 31 percent of the samples. VIN III (extremely abnormal cells) was evident in over 50 percent of specimens with lichen sclerosus. Human papilloma virus infection was detected in 6 of 11 VIN lesions, but was absent in the six lichen sclerosus lesions that were examined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Squamous cell carcinoma, Vulvar cancer

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