Cases reported "Placenta Diseases"

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1/11. Villitis of known origin: varicella and toxoplasma.

    Chronic villitis is a common condition in human placentae. In some cases an infectious cause can be demonstrated, such as infection with cytomegalovirus and rubella virus. Most often it is of unknown aetiology, the so-called VUE (villitis of unknown aetiology). We describe two cases with identification of specific infectious agents, each demonstrating previously unreported findings, i.e. persistent varicella antigen in the villi in case 1, and presence of toxoplasma cysts in Wharton's jelly in case 2. The identification of the pathogens, varicella virus and toxoplasma, would easily have been overlooked in routine study of the placenta and were possible because of clinical suspicion.
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ranking = 1
keywords = virus
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2/11. measles virus infection in the placenta of monozygotic twins.

    We report a case of monozygotic twins whose mother was infected with measles at 19 weeks' gestation. One of the twins died in utero at 32 weeks' gestation. The placenta of the stillbirth showed massive fibrin deposition, and some residual trophoblasts contained many inclusion bodies positive for measles virus antigen. Fetal organs and cells other than a few splenic lymphocytes showed no evidence of measles virus infection. The placenta of the surviving infant showed focal intervillous fibrin deposits, and only a few syncytiotrophoblasts were positive for measles virus antigen. At present, 7 months after the delivery, the surviving infant has not developed any sign of measles virus infection. Postpartum course of the mother has been uneventful, although high titers of serum anti-measles virus IgM persisted for 6 months after delivery. This case is informative in the following respects: the villous trophoblasts had diagnostic inclusion bodies and ultrastructural evidence of measles virus infection, the degree of viral involvement within the monochorionic placenta was uneven, both of the twins were virtually free from measles virus infection despite the marked involvement of the placenta, and measles virus infection had persisted in the monochorionic placenta for approximately 13 weeks.
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ranking = 6451.2087693565
keywords = measles virus, measles, virus
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3/11. Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn.

    OBJECTIVE: To determine if viral infection of the placenta was associated with long-term neurodevelopmental delays in the newborn. methods: Placental tissue from seven newborn infants with severe respiratory failure and subsequent neurodevelopmental abnormalities as well as ten normal controls and five cases of known placental infection (cytomegalovirus, herpes simplex virus, and parvovirus) were tested by in situ hybridization or reverse transcriptase in situ polymerase chain reaction (PCR) for adenovirus, coxsackie virus, cytomegalovirus, Epstein Barr virus, herpes simplex virus, influenza a virus, picornavirus, polyoma virus, parvovirus, respiratory syncytial virus, rotavirus, and varicella zoster virus. RESULTS: Coxsackie virus rna was detected in six of the seven cases, and in none of the ten normal controls or five cases with known viral infection. Viral rna localized primarily to the Hofbauer cells and trophoblasts of the terminal villi. Immunohistochemical analysis for the coxsackie virus antigen VP1 yielded equivalent results. CONCLUSIONS: In utero coxsackie virus of the placenta is associated with the development of severe respiratory failure and central nervous system sequelae in the newborn. This underscores the importance of detailed pathologic and viral examination of the placenta in cases of systemic illness in the newborn.
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ranking = 7.3333333333333
keywords = virus
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4/11. Characterization of the fetal inflammatory response to cytomegalovirus placentitis. An immunohistochemical study.

    The histopathologic features of cytomegalovirus placentitis, an established cause of chronic villitis, are well documented. However, the immunologic features of the fetal inflammatory response to placental cytomegalovirus infection are largely unknown. The characterization of the fetal-derived inflammatory cell reaction may be important in our understanding of both the intrauterine as well as the antenatal immunological response of the neonate to this important viral infection. We examined formalin-fixed placentas from four cases of confirmed congenital cytomegalovirus infection using an in situ dna probe to cytomegalovirus, and a variety of antibodies to leukocyte antigens, including anti-CD68, CD45RO, CDw75, CD74, IgG, IgM, and IgA. All four placentas showed marked hyperplasia of fetal-derived placental macrophages, termed Hofbauer cells. A lymphocytic villitis was present in all placentas, which was characterized by positive staining in all cases with T-cell antibodies. There was no evidence of positive staining of lymphocytes using B-cell antibodies in any of the cases. Two placentas showed plasmacellular villitis, which stained positively for both IgG- and IgM-secreting cells, that was present as early as the second trimester of gestation. No IgA positivity of plasma cells was observed. These data are presented in light of current theories of fetal viral immunity.
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ranking = 2.6666666666667
keywords = virus
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5/11. Vascular anastomoses in dichorionic diamniotic-fused placentas.

    A case of fetal twin-to-twin cytomegalovirus infection through a dichorionic diamniotic (DiDi)-fused placenta prompted our search for possible vascular anastomoses in this type of placenta. This case and three additional DiDi-fused placentas were studied with gross (macro) sections and a three-dimensional (3D) stereomicroscopic technique. Two twins were dizygotic (they differed in gender and blood groups) and the other two were probably monozygotic. Macrosections and 3D-image analysis demonstrated side-to-side connections between small subchorionic vessels. These findings demonstrate that vascular anastomoses are present in DiDi-fused placentas.
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ranking = 0.33333333333333
keywords = virus
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6/11. herpes simplex virus infection of the placenta. The role of molecular pathology in the diagnosis of viral infection of placental-associated tissues.

    herpes simplex infections of the placenta and its associated tissues are rarely seen and, consequently, the pathologic features are not well understood. We describe the occurrence of herpes simplex virus infection of the placenta that was limited to maternal-derived cells of the subchorionic tissue. The microscopic findings were remarkable for both the absence of inflammation and characteristic viral inclusions. However, in situ dna hybridization, as well as immunohistochemistry using antibody to herpes simplex virus type 2, revealed herpes virus infection of decidualized cells in the decidua capsularis. The significance of this finding, and the importance of molecular techniques for the diagnosis of herpes virus infection in placental pathology, are discussed.
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ranking = 2.6666666666667
keywords = virus
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7/11. Viral placentitis - a case report.

    A case of viral placentitis, in a 20 year-old pregnant woman suffering from chronic glomerulonephritis, was presented. In light microscopic findings of the placenta, many necrotic foci with intranuclear inclusion - bearing cells revealed in chorionic villi and by electron microscopy numerous immature and mature virus particles, probably herpes simplex were proved in intranuclear inclusion-bearing cells.
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ranking = 0.33333333333333
keywords = virus
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8/11. Report of fourteen cases of nonimmune hydrops fetalis in association with hemorrhagic endovasculitis of the placenta.

    Hemorrhagic endovasculitis of the placenta is a distinct vasodestructive process of unknown cause that has been associated with perinatal morbidity and mortality. A relationship between nonimmune hydrops fetalis and hemorrhagic endovasculitis has not been previously described. At a large teaching hospital, six cases of nonimmune hydrops fetalis were identified out of 72 cases of hemorrhagic endovasculitis over 6 years, for an incidence of 8%. Conversely, these same six cases represented 24% of the 25 cases of nonimmune hydrops fetalis from this time period. Eight additional cases of nonimmune hydrops fetalis were found among 2064 cases of hemorrhagic endovasculitis at the michigan Placental Tissue Registry. In eight of the total 14 cases, after congenital malformations and cytomegalovirus infections were excluded, hemorrhagic endovasculitis was the only significant associated pathologic finding evident. The significance of the relationship between nonimmune hydrops fetalis and the vascular abnormalities of hemorrhagic endovasculitis remains to be determined.
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ranking = 0.33333333333333
keywords = virus
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9/11. fetal death associated with measles virus infection of the placenta.

    A case of fetal death at 25 weeks' gestation, which was associated with maternal measles infection, is described. Immunohistochemical study revealed measles virus antigen in the syncytial trophoblastic cells and decidua but not in the fetus. Results suggest that fetal death was caused by measles virus infection in the placenta. As far as we know, this is the first report in which a measles virus antigen was detected in the placenta by the immunohistochemical method.
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ranking = 5644.2768223355
keywords = measles virus, measles, virus
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10/11. Fetal ventriculomegaly and brain atrophy in a woman with intrauterine cytomegalovirus infection. A case report.

    Fetal ventriculomegaly and brain atrophy occurred in a woman with intrauterine cytomegalovirus infection.
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ranking = 1.6666666666667
keywords = virus
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