The changes in Hoffbauer and syncytiotrophoblast cells in serious preeclampsia complicated with hellp syndrome (Ultrastructural and immunohistochemical study)

Abstract

HELLP syndrome is a syndrome characterized by hemolytic anemia, increased liver enzymes, and thrombopenia and can be seen in 1% of all pregnancies, 10-20% of pregnancies with pain, preeclampsia, and eclampsia. HELLP syndrome usually develops in the third trimester and its pathogenesis is not clear. Human placental villus stroma contains macrophages called Hoffbauer cells (HC), which are thought to be involved in many processes. HC is also called placental macrophage and has a role in many placental events. This study aimed to evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblast and Hoffbauer cells in the placental villi of HELLP syndrome patients. In our study, placental tissues obtained from human normal and HELLP syndrome pregnancies were prepared for light and transmission electron microscopy (TEM) studies. Immunohistochemistry techniques were applied to placenta sections. HC localizations were determined with CD68 (Hoffbauer cell marker). Fine structure properties of HC and syncytiotrophoblasts were examined by TEM. When the HELLP group fetal placental sections were examined under the light microscope, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles, and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The increase in the number of Hoffbauer cells per villus in the HELLP group was statistically significant (p<0.00). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblast in HELLP group, and also degenerative changes were observed in the ultrastructural structure of these cells.