Histopathology of the placenta in HIV positive women

Zungu, Mondi (2015-12)

Thesis (MMed)--Stellenbosch University, 2015.

Thesis

ENGLISH ABSTRACT: Objectives To describe the histopathological (macro- and microscopic) findings in placentae of mothers with HIV and to investigate the influence of maternal ARV therapy on histopathology, as well as to investigate the influence of immune suppression (CD4 count) on histopathology. Methods A retrospective audit of placentae collected between 2009 and 2010 from mothers with HIV disease was performed. Placentae were examined according to the standard protocol used by the Division of Anatomical Pathology (Appendix B). Data were extracted from the files and reports by the MMed student and loaded onto a database in a strictly anonymous fashion. Women with HIV plus co-morbidities specifically affecting placental function such as diabetes mellitus and pre-eclampsia were noted but not excluded from the study. Results There were 200 HIV cases that were identified during the study. Of the 200 cases 196 had histopathology results. The main placental findings in the study were that of maternal vascular under-perfusion (36%), ascending infection (29%) including chorioamnionitis and small placenta (15%). However, there was no significant difference in pathological diagnostic groups between the CD4 counts of the less than or greater than 350 cells/mm3. Conclusion Maternal vascular under-perfusion, ascending infection and small placenta may be linked to HIV placental infection, but further higher powered, controlled studies need to be done.

AFRIKAANSE OPSOMMING: Mikpunte Om die histopatologiese (makro- en mikroskopies) bevindinge in plasentas van moeders met HIV te omskryf en die invloed van moederlike ARV terapie op histopatologie te ondersoek, asook die invloed van immuun onderdrukking (CD4 telling) op histopatologie te ondersoek. Metodes ‘n Retrospektiewe oudit van plasentas wat gedurende 2009 en 2010 gekollekteer is van moeders met HIV is uitgevoer. Plasentas is ondersoek deur gebruik te maak van die standaard protokol wat deur die Afdeling Anatomiese Patologie gebruik word (Aanhangsel B). Data is deur die MMed student versamel uit leêrs en verslae en op ‘n databasis gelaai op ‘n streng anonieme wyse. Vroue met HIV en ko-morbiditeite soos diabetes en preëklampsie, wat spesifiek plasentale funksie affekteer, is opgeteken maar nie uitgesluit van die studie nie. Resultate Daar is 200 HIV gevalle gedurende die studie geïdentifiseer. Uit 200 gevalle het 196 histopatologie resultate gehad. Die hoof plasentale bevindinge in die studie was moederlike vaskulêre onder-perfusie (36%), opstygende infeksie (29%) insluitende chorioamnionitis en klein plasenta (15%). Nietemin was daar geen merkbare verskil in patologies diagnostiese groepe tussen die CD4 telling van minder as of meer as 350 selle/mm3. Gevolgtrekking Moderlike vaskulêre onder-perfusie, opstygende infeksie en klein plasenta mag verbind word met HIV plasentale infeksie, maar verdere groter gekontrolleerde studies moet gedoen word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/97997
This item appears in the following collections: