Morphological and immunohistochemical features of placenta in postpartum women with hyperprolactinemia history

Authors

  • T. D. Zadorozhna State Institution “Institute of Pediatrics Obstetrics and Gynecology Named Academic Elena M. Lukyanova National Academy of Medical Sciences of Ukraine”, Kyiv, https://orcid.org/0000-0001-8819-8901
  • E. V. Kolomiiets State Institution “Institute of Pediatrics Obstetrics and Gynecology Named Academic Elena M. Lukyanova National Academy of Medical Sciences of Ukraine”, Kyiv, https://orcid.org/0000-0003-4511-1663
  • L. Ye. Tumanova State Institution “Institute of Pediatrics Obstetrics and Gynecology Named Academic Elena M. Lukyanova National Academy of Medical Sciences of Ukraine”, Kyiv, https://orcid.org/0000-0002-4202-943X
  • S. M. Kylykhevych State Institution “Institute of Pediatrics Obstetrics and Gynecology Named Academic Elena M. Lukyanova National Academy of Medical Sciences of Ukraine”, Kyiv, https://orcid.org/0000-0002-9312-7785

DOI:

https://doi.org/10.14739/2310-1237.2020.3.221780

Keywords:

placenta, immunohistochemistry, prolactin

Abstract

 

Hyperprolactinemia (HP) is a persistent increase in serum prolactin levels, the most typical manifestation of which is a dysfunction of the reproductive system. Pregnant women with HP have a high incidence of perinatal complications; thus, the threat of self-abortion in these women is more than 48.4 %, and in 16.1 % of pregnant women it ends in premature birth. These patients often develop placental abnormalities that lead to fetal distress during pregnancy and childbirth.

The aim: to investigate the morphological and immunohistochemical changes in the placental barrier, taking into account the expression of prolactin in postpartum women with a history of hyperprolactininemia.

Materials and methods. In 30 puerperas with a history of endocrine infertility associated with hyperprolactinemia (group 1) and in 27 healthy puerperas without hyperprolactinemia and infertility (control group 2), the morphological features of the placentas were studied in the gestational period of 39–40 weeks using organometric, macroscopic, histological and immunohistochemical (IHC) methods.

IHC studies were carried out on serial paraffin sections in accordance with standard protocols using monoclonal antibodies to prolactin (Rabbit a-Нu Prolactin Monoclonal Antibody (Clone EP 193) master diagnostica (Spain) and detection system Thermo scientific (USA).

Results. The placenta weight of women in labor with hyperprolactinemia did not differ significantly from the weight of the placenta of women in labor without hyperprolactinemia. In 22 (73.3 %) postpartum women with hyperprolactinemia in the placenta, paracentral attachment of the umbilical cord took place, in 4 (13.3 %) patients malformation of the umbilical cord vessels was detected, in 7 (23.3 %) postpartum women significant stenosis and closure of the arterial lumen vessels of the umbilical cord were found. Histological examination of women in labor with hyperprolactinemia identified focal thickening of the decidua with the presence of significant fibrinoid masses (n = 18, 60 %), microbleeds and thinning of the decidua (n = 8, 26.6 % of women in labor). A number of observations revealed the presence of maternal internal infarctions with perivillous fibrin deposition, in 12 (40 %) postpartum women, the presence of fibrinoid-embedded villi with the replacement of the villus epithelium with fibrinoid masses was noted, in 15 (50 %) women fibrosis and collagenization of the stem and middle chorionic villi, fibrosis of small villi and avascular small villi was observed in 12 (40 %) postpartum women. In some observations, a decrease in the number of syncytial nodes and syncytiocapillary membranes was noted in the terminal villi. IHC study of the placenta of postpartum women with hyperprolactinemia in the gestational period of 39–40 weeks revealed multiple foci of decidual cells with overexpression of prolactin in the cytoplasm.

Conclusions. Morphological changes in the placenta of postpartum women with hyperprolactinemia in anamnesis differ from changes in the placenta of women without hyperprolactinemia by the presence of focal vascular changes in the decidual membrane with its partial detachment and internal infarctions in the maternal part of the placenta, as well as by the presence of signs of partial perfusion disorders of the fetal foci placenta.

In the placenta of women with hyperprolactinemia, immunohistochemical study revealed a long-term focal significant cytoplasmic expression of prolactin in the cells of the decidual membrane, which indicates disorders of prolactin synthesis in the body and discoordination in the work of the endocrine system of women.

References

Antypkin, Yu. H., Zadorozhna, T. D., & Parnytska, O. I. (2016). Patolohiia platsenty (suchasni aspekty) [Placenta pathology (мodern aspects)]. Kyiv. [in Ukrainian].

Aylamazyan, E. K., Lapina, E. A., & Kvetnoy, I. M. (2005). Immunogistokhimicheskie kriterii otsenki funktsionalnoi zrelosti platsenty [Immunohistochemical criteria of the functional placental maturity estimation]. Zhurnal akusherstva i zhenskikh boleznei, 54(2), 2-10. [in Russian].

Tronko, M. D., Antypkin, Yu. H., Kaminskyi, V. V., & Tatarchuk, T. F. (2017). Natsionalnyi konsensus shchodo vedennia patsiientiv z hiperprolaktynemiieiu 2016 [National Consensus on the Management of Patients with Hyperprolactinemia 2016]. Medychni aspekty zdorovia zhinky, (1), 32-42. [in Ukrainian].

Binart N. (2016). Prolactin and pregnancy in mice and humans. Annales d'endocrinologie, 77(2), 126-127. https://doi.org/10.1016/j.ando.2016.04.008

Bukowski, R., Hansen, N. I., Pinar, H., Willinger, M., Reddy, U. M., Parker, C. B., Silver, R. M., Dudley, D. J., Stoll, B. J., Saade, G. R., Koch, M. A., Hogue, C., Varner, M. W., Conway, D. L., Coustan, D., Goldenberg, R. L., & Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Stillbirth Collaborative Research Network (SCRN) (2017). Altered fetal growth, placental abnormalities, and stillbirth. PloS one, 12(8), e0182874. https://doi.org/10.1371/journal.pone.0182874

Jones, C. J., Carter, A. M., Allen, W. R., & Wilsher, S. A. (2016). Morphology, histochemistry and glycosylation of the placenta and associated tissues in the European hedgehog (Erinaceus europaeus). Placenta, 48, 1-12. https://doi.org/10.1016/j.placenta.2016.09.010

Khong T. Y., Mooney E. E., Nikkels, P. G. J., Morgan, T. K., & Gordijn, S. J. (Eds.). (2019). Pathology of the placenta. A Practical Guide. Springer Nature Switzerland. https://doi.org/10.1007/978-3-319-97214-5

Khong, T. Y., Ting, M., & Gordijn, S. J. (2017). Placental pathology and clinical trials: Histopathology data from prior and study pregnancies may improve analysis. Placenta, 52, 58-61. https://doi.org/10.1016/j.placenta.2017.02.014

Khong, T. Y., Mooney, E. E., Ariel, I., Balmus, N. C., Boyd, T. K., Brundler, M. A., … Gordijn, S. J. (2016). Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement. Archives of pathology & laboratory medicine, 140(7), 698-713. https://doi.org/10.5858/arpa.2015-0225-CC

Lenke, L., Martínez de la Escalera, G., Clapp, C., Bertsch, T., & Triebel, J. (2020). A Dysregulation of the Prolactin/Vasoinhibin Axis Appears to Contribute to Preeclampsia. Frontiers in endocrinology, 10, 893. https://doi.org/10.3389/fendo.2019.00893

Olmos-Ortiz, A., Déciga-García, M., Preciado-Martínez, E., Bermejo-Martínez, L., Flores-Espinosa, P., Mancilla-Herrera, I., Irles, C., Helguera-Repetto, A. C., Quesada-Reyna, B., Goffin, V., Díaz, L., & Zaga-Clavellina, V. (2019). Prolactin decreases LPS-induced inflammatory cytokines by inhibiting TLR-4/NFκB signaling in the human placenta. Molecular human reproduction, 25(10), 660-667. https://doi.org/10.1093/molehr/gaz038

Redline R. W. (2015). Classification of placental lesions. American journal of obstetrics and gynecology, 213(4 Suppl), S21–S28. https://doi.org/10.1016/j.ajog.2015.05.056

Senagore, P. K., Holzman, C. B., Parks, W. T., & Catov, J. M. (2016). Working Towards a Reproducible Method for Quantifying Placental Syncytial Knots. Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society, 19(5), 389-400. https://doi.org/10.2350/15-08-1701-OA.1

Downloads

How to Cite

1.
Zadorozhna TD, Kolomiiets EV, Tumanova LY, Kylykhevych SM. Morphological and immunohistochemical features of placenta in postpartum women with hyperprolactinemia history. Pathologia [Internet]. 2020Dec.29 [cited 2024Apr.18];(3). Available from: http://pat.zsmu.edu.ua/article/view/221780

Issue

No. 3 (2020)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Лицензия Creative Commons
    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).