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    Expression of beta human chorionic gonadotropin in the placenta of gestational diabetic mothers: An immunohistochemistry and ultrastructural study
    (2013) Sak M.E.; Deveci E.; Evsen M.S.; Kalkanli S.; Baran O.; Özekinci S.; Şeker U.
    Objective: To investigate morphologic differences of the placenta in pregnancies complicated by gestational diabetes compared to nondiabetic pregnancies. Study Design: This was a comparative morphological study of the placentas from 20 women with gestational diabetes and 20 healthy pregnancies at 28-35 weeks of gestation. Results: The presence of lesions such as fibrinoid necrosis, villous edema, syncytial knot and vascular lesions like chorangiosis was apparent, mainly in the diabetes group. There was an apparent decrease in the intensity of the human chorionic gonadotropin (hCG) immunostaining in the syncytiotrophoblast from the 28th to 35th weeks of gestation in the placentas of the healthy control group. No hCG immunostaining was observed in the villous or intervillous areas of any of the placentas. In diabetic placentas the expression of hCG was homogeneous with a moderate to intense immunoreactivity in the syncytiotrophoblast. Several syncytiotrophoblast cells showed dilations of both rough and smooth endoplasmic reticulum and loss and alteration of microvilli, and large vacuoles were observed just below the plasma membrane, as well as irregularities in the mitochondria. Conclusion: Syncytial cells play an important role in the placental transition. Increased expression of ß- hCG, deterioration, degeneration of organelles and cell structure and the basal membrane disorder in chorionic vessels were seen in placentas with gestational diabetes. These changes can affect placental transfer. However, further studies are needed to clarify this issue. © Science Printers and Publishers, Inc.
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    Human placental macrophages (Hofbauer cells) in severe preeclampsia complicated by HELLP syndrome
    (2013) Evsen M.S.; Kalkanli S.; Deveci E.; Sak M.E.; Ozler A.; Baran O.; Erdem E.
    OBJECTIVE: To evaluate Hofbauer cells in the placentas of women diagnosed with HELLP syndrome. STUDY DESIGN: The present study compared 20 patients with HELLP syndrome and 20 control patients with respect to demographics, hematological parameters and the presence of Hofbauer cells in placental samples. CD-68 antibody was used for immunohistochemical examination. The total number and size of Hofbauer cells were measured in the placental villi, and the proportion of Hofbauer cells relative to the vascular structure was also compared between groups. RESULT: The patient and control groups were similar according to baseline obstetric characteristics. White blood cell counts in patients with HELLP syndrome and the control group were 15,139 ± 4,169 and 10,806 ± 2,888, respectively, and were significantly increased among patients with HELLP syndrome (p<0.001). Hofbauer cell numbers in the placental villi of patients with HELLP syndrome were significantly elevated in comparison to normotensive controls (p=0.046). The proportion of Hofbauer cells in the placental villi according to proximity to the vascular structure were 3.85±1.66 in the HELLP group and 1.75±1.12 in controls (p<0.001). Sizes of the Hofbauer cells were not statistically different between groups. CONCLUSION: Increased Hofbauer cells may be associated with increased inflammation or may have an adaptive mechanism at the fetal site of the placenta in patients with HELLP syndrome. (Anal Quant Cytopathol Histopathol 2013;35:283-288). © Science Printers and Publishers, Inc.