J Pathol Transl Med.  2017 Sep;51(5):488-498. 10.4132/jptm.2017.07.20.

Placental Lesions in Meconium Aspiration Syndrome

• Kim B
• Oh SY
• Kim JS

• KMID: 2392568
• DOI: http://doi.org/10.4132/jptm.2017.07.20

Abstract

BACKGROUND
Meconium aspiration syndrome (MAS) is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. MAS is clinically subclassified as mild, moderate, and severe according to the oxygen requirement. The aims of this study were to compare the histological findings in the placentas of MAS neonates with those of meconium-stained but non-MAS neonates and to analyze the correlation between the severity of MAS and the grade of its histological parameters.
METHODS
We collected 160 singleton term placentas from neonates with meconium staining at birth from a tertiary medical center, Seoul, Republic of Korea. We reviewed hematoxylin and eosin sections of tissue samples (full-thickness placental disc, chorioamniotic membranes, and umbilical cord).
RESULTS
Funisitis was present more frequently in MAS than in non-MAS (p < .01), of which the stage was correlated with the severity of MAS (p < .001). The histological findings consistent with maternal underperfusion and chronic deciduitis were more frequent in MAS than in non-MAS (p < .05). There was a correlation between the degree of chorionic vascular muscle necrosis and the severity of MAS (p < .05).
CONCLUSIONS
Our results suggest that fetal inflammatory response evidenced by funisitis occurs prenatally in MAS and that the stage of funisitis and of chorionic vascular muscle necrosis may be a predictive marker of the severity of MAS.

Keyword

Placenta; Meconium; Meconium aspiration syndrome; Chorioamnionitis; Chorionic vascular muscle necrosis

MeSH Terms

Chorioamnionitis
Chorion
Eosine Yellowish-(YS)
Female
Hematoxylin
Humans
Infant, Newborn
Meconium Aspiration Syndrome*
Meconium*
Membranes
Necrosis
Oxygen
Parturition
Placenta
Pregnancy
Republic of Korea
Seoul
Eosine Yellowish-(YS)
Hematoxylin
Oxygen

Figure

• 

  Fig. 1. Representative histological findings of the placenta. (A) Acute chorioamnionitis. (B) Funisitis. (C) Increased syncytial knots. (D) Chronic villitis. (E) Chronic deciduitis. (F) Chorionic vascular muscle necrosis.

• 

  Fig. 2. Comparison of the frequencies of histological findings in the placentas between meconium aspiration syndrome (MAS) and non-MAS placentas. (A) Acute chorioamnionitis. (B) Funisitis. (C) Amniotic fluid infection. (D) Maternal underperfusion. (E) Fetal thrombo-occlusive disease. (F) Chronic inflammation. (G) Chronic villitis. (H) Chronic chorioamnionitis. (I) Chronic deciduitis. (J) Meconium-laden macrophages. (K) Amnion degeneration. (L) Chorionic vascular necrosis. VUE, villitis of unknown etiology.

• 

  Fig. 3. Correlation of the severity of the histological findings in the placentas with the severity of meconium aspiration syndrome (MAS). (A) Funisitis vs MAS. (B) Chorionic vascular muscle necrosis (CVMN) vs MAS. (C) Maternal underperfusion (MU) vs MAS.

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