Fetal death due to vascular malformation of the placenta. 4 unusual cases and pathogenesis

Purpose: Intrauterine death in the early fetal periode is to be due more frequently to infection and lethal malformations and only rarely to pathological developmental conditions within the placenta. The manifestation of an intrauterine anoxia in the early fetal period must be considered as unusual, speaks it nevertheless for the fact that in an early point of development time a pronounced insufficiency of the placenta is already present. Material and Methods: Clarifying the pathogenesis, 4 placentas of intrauterine deceased fetus became 14. to 22. gestational week with abnorm high vascularity during simultaneous maturational arrest examines. The placentas indicated on the one hand angiopathies and growth disturbances, which led in the long run all to the obviously reactively increased container formation. The angiogenic growth always shows a dependency on growth factors and so we showed to the expression of VEGF as well as its receptors Flt-1 and KDR, primary fibroblastic growth factor (bfgf) and Angiopoietin-1 examines. Results: Immunohistochernically a strong expression of all growth factors pointed itself to numerous cells of the villous, thus in trophoblast cells, hofbauer cells and endothel cells. This makes clear that all examined antibodies are involved in the development of the early placenta period. Differences regarding the expression of the growth factors in the placentas with hypervascularisation and as the normal control placentas did not examine morphologically. Conclusion: It obviously concerns it an adjustment reaction of the villous to the hypoxia. In the early pregnancy the growth retardation or pathological flow values must be interpreted as warning signals.