Background

Placentas from outlying hospitals are formalin-fixed en route to our laboratory. We identified that chorionic, stem villus, and umbilical vessels in these fixed placentas are ectatic with greater frequency than in our in-house fresh placentas.

Methods

We searched our LIS for third trimester placentas using keywords “ectasia” or “ectatic” over a 12-month period. We fixed incoming in-house placentas over a 2-week period for 24–72 hours and tabulated the presence or absence of vascular ectasia as defined by Parast et al, 2008.

Results

The LIS search identified 61% of placental cases from outlying hospitals that had ectatic vessels vs 3% of in-house placentas (P < .001). Of 38 placentas fixed in a 2-week period, 45% had ectatic chorionic or stem villus vessels and 21% had umbilical vessel ectasia. In comparison, in the 2 subsequent weeks, 3.8% (P < .001) of fresh placentas had vascular ectasia.

Conclusion

These data suggest that large fetal vessels in the placenta become engorged with blood at delivery and, if fixed soon after delivery, remain ectatic and congested when processed for pathology. The identification of artifactual ectasia is important because fetal vessel ectasia can suggest the presence of fetal vascular malperfusion (FVM) if diagnostic signs of FVM are present.

中文翻译：

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胎儿血管扩张可能是胎盘固定的产物

背景

来自边远医院的胎盘在送往我们实验室的途中被福尔马林固定。我们发现这些固定胎盘中的绒毛膜、茎绒毛和脐血管比我们内部的新鲜胎盘更频繁地扩张。

方法

我们在 12 个月内使用关键字“扩张”或“扩张”在 LIS 中搜索了妊娠晚期胎盘。我们在 2 周内固定传入的内部胎盘 24-72 小时，并将 Parast 等人，2008 年定义的血管扩张的存在或不存在制成表格。

结果

LIS 搜索发现 61% 的胎盘病例来自具有扩张血管的外围医院，而内部胎盘的这一比例为 3% ( P < .001)。在 2 周内固定的 38 个胎盘中，45% 有绒毛膜或茎绒毛血管扩张，21% 有脐血管扩张。相比之下，在随后的 2 周内，3.8% ( P < .001) 的新鲜胎盘出现血管扩张。

结论

这些数据表明，胎盘中的大胎儿血管在分娩时会充满血液，如果在分娩后不久就固定下来，在进行病理学处理时仍会保持扩张和充血。人工扩张的识别很重要，因为如果存在 FVM 的诊断体征，胎儿血管扩张可能表明存在胎儿血管灌注不良 (FVM)。