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The effects of syncytin-1, syncytin-2 and ASCT2 for the cell fusion in human placental BeWo cells
Abstracts / Placenta 34 (2013) A1–A17 1 Okinawa Churashima Foundation, Okinawa, Japan; 2 Department of Molecular Pathology, Tokyo Medical University,Tokyo, Japan; 3 Electron Microscopy, Tokyo Medical University, Tokyo, Japan; 4 Morphology Division, Saitama Medical University, Saitama, Japan
Abstract Objective: The ocean mammals such as whales, dugong and manatee produce placentation in the uterus, but Manta ray belonging to the family of Elasmobranch does not only produce placentation in the uterus, but only makes densely developed villous strings called trophonemata. Although its morphologic characters have been clarified by histochemical and ultrastructural studies (Soma, 2013), it is, however, still unknown how the fetus could be nourished by trophonemata in the uterus of Manta ray. Methods: 1) The ultrastructural differences between the non-gravid uterus and the gravid uterus of Manta alfredi were compared. 2) Ultrasonic images between the fetal movement and trophonemata in utero of Manta alfredi were visualized by the use of ultrasonar machine in the large water tank of the aquarium. Results: 1) In contrast with proliferation of the endometrial cells in the non-gravid uterus of Manta ray, very densely growth patterns of trophonemata including many secretory granules could be illustrated in the gravid uterus. 2) Using the ultrasonar machine, growth pattern of trophonemata and the fetal growth as well as the uptake ways of respiration and nutrients can be recognized. Conclusions: The development of fetus with trophonemata could be reflected in the gravid uterus of Manta ray. http://dx.doi.org/10.1016/j.placenta.2013.07.033 No.21 ALTERATION OF PROTEASE SYSTEM AND DAMPS ON HUMAN TERM PLACENTAL TROPHOBLAST UNDER HYPOXIC CULTURE Katsuhiko Naruse, Taihei Tsunemi, Natsuki Koike, Akira Onogi, Juria Akasaka, Chiharu Uekuri, Hidekazu Oi, Hiroshi Kobayashi Nara Medical University, Nara, Japan
Abstract Background: MMP (Matrix metalloproteinase) is zinc-required protease and may be involved in the formation and maintenance of human placenta. We reported alteration of the MMP system under hypoxic stimulation in primary human extravillous trophoblast from early gestation (Onogi A, et al. Placenta, 2011). In this study, we examined alterations of proteases and HMGB1, a major molecule in DAMPs (Danger Associated Molecular Patterns), to suggest the effect of placental hypoxia on maternal complications in the 3rd trimester of pregnancy. Methods: Placenta was taken from healthy elective Caesarean section patients. Trophoblasts were separated using trypsin and PercollR, and cultured under 20% oxygen with or without 3 rounds of 0.1% hypoxic stimulation for 1 hour. MMP-2 and TIMP-2 concentrations were measured with multiple cytokine ELISA array, and HMGB1 was measured with ELISA assay. Results: Concentrations of MMP-2 and TIMP-2 in the trophoblast culture supernatant were decreased in hypoxic stimulation compared to normal culture. Significant increase of HMGB1 was observed in hypoxic culture compared to normal culture. Conclusions: MMP-2 and TIMP-2, which known as the protease system dominantly exists in the placenta and uterus were suppressed in hypoxic condition, maybe for the maintenance or proliferation of the placenta. We reported a peripheral increase of HMGB1 in the patient of early onset severe preeclampsia (Naruse K, et al. J Reprod Immunol, 2012). Placental release of HMGB1, the “danger signal” works as a fetal messenger and a
A9
trigger for systemic inflammation may be a key circumstance of fetomaternal conflict in pregnancy. http://dx.doi.org/10.1016/j.placenta.2013.07.034
No.22 A CASE OF PMD WITH THE HIGH MATERNAL SERUM LEVELS OF SFLT-1 Sameshima Azusa 1, Noriko Yoneda 1, Msahito Morijiri 1, Rika Yonezawa 1, Satoshi Yoneda 1, Arihiro Shiozaki 1, Ritsuko K. Pooh 2, Masahiro Nakayama 3, Hidenobu Soejima 4, Shigeru Saito 1 1
Department of Obstetrics and Gynecology, University of Toyama, Japan; CRIFM Clinical Research Institute of Fetal Medicine PMC, Japan; 3 Department of Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan; 4 Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Japan 2
Abstract Placental mesenchymal dysplasia (PMD) is a rare placental anomaly characterized by a hydropic placenta and depicting multiple cysts, and there are few PMD cases complicated with maternal disorder. We have experienced a case of PMD with preeclampsia. A 31-year-old woman (3G0P) suffering from three times miscarriages had been taking low-dose aspirin therapy. Multiple cystic lesions in the placenta were noted on ultrasound examination at 10 weeks of gestation. The maternal serum hCG level was high at 360,000 IU per L, but the karyotype of villus showed a normal 46,XY, suggested a diagnosis of PMD. She was admitted at 20 weeks of gestation because of preclampsia. The fetal growth is normal, but polyhydramnions was observed. On 26 weeks and 0 days of gestation, she complained of increased labor pain, and therefore a cesarean section was performed. The male baby weighed 812g (0.0SD) and Apgar scores were 2 and 7 points at 1 and 5 min. The newborn showed persistent hypoglycemia without macroglassia or hernia of the umbilical cord. Histological examination showed multiple hydropic cysts, stromal hypercellularity and cistern formation in the part of placenta. Vascular anomalies were not observed. The epigenetic analysis of the placenta and cord blood confirmed BWS, because of the loss of methylation at KvDMR1. The maternal serum and cystic fluid of placenta levels of soluble fms-like tyrosine kinase-1 (sFlt-1) were extremely high (88,000 pg per mL and 171,000 pg per mL) compared with those reported in preeclampsia, suggesting an angiogenic imbalance may have caused preeclampsia with severe proteinuria. http://dx.doi.org/10.1016/j.placenta.2013.07.035
No.23 THE EFFECTS OF SYNCYTIN-1, SYNCYTIN-2 AND ASCT2 FOR THE CELL FUSION IN HUMAN PLACENTAL BEWO CELLS Takahiro Nobuzane, Yoshiki Kudo Department of Obstetrics and Gynecology, Hiroshima University, Japan
Abstract Introduction: Syncytin-1 and syncytin-2, the human endogenous retrovirus envelope proteins, are highly expressed in the placenta, and contributes to placental fusion. ASCT2 is a syncytin-1 receptor. The alteration of these gene expressions in pre-eclampsia has been reported. To investigate the effects of syncytin-1, syncytin-2 and ASCT2 for fusion activity, we use siRNA technique in human placental BeWo cells.
A10
Abstracts / Placenta 34 (2013) A1–A17
Methods: BeWo cells was treated with siRNA for each of syncytin-1, syncytin-2 or ASCT2 and both of syncytin-1 and 2, followed by incubation with forskolin to become fusion. The cell-fusion activity was evaluated by flow-cytometry. Results: The mRNA expression of syncytin-1 syncytin-2 and ASCT2 were reduced after incubation of its specific siRNA treatment. The fusion number was reduced only in syncitin-1 specific siRNA treatment group. Discussion: This result suggests that syncytin-1, rather than syncytin-2, has strong effect for cell-fusion in BeWo cells. http://dx.doi.org/10.1016/j.placenta.2013.07.036 No.24 EXPRESSION PLACENTA
OF
TOLL-LIKE
RECEPTORS
IN
HUMAN
PRETERM
Hiroaki Moroi, Takafumi Ushida, Shima Hirakou, Masako Sawada, Tomoko Nakano, Yuka Hattori, Yuriko Watanabe, Yukio Mano, Hiroyuki Tsuda, Seiji Sumigama, Hidenori Takahashi, Tomomi Kotani, Fumitaka Kikkawa
Material: I reexamined 74 cases ; placental and villi. Results: This investigation looked at 50 cases of early abortion which is until the 11th week of pregnancy. Eight of the abortions were due to placental dysmature villi. For the other 4 cases we found that there was a lot of fibrin deposition around the villi. For the late abortion stage which is from the 12th to the 21st weeks of pregnancy, we looked at 34 cases. I determined that in 16 cases, there was a highly inflammatory cell invasion which may have been caused by infection. Another 6 cases showed dysmature villi, which shows that the same issue continues into the 21st week. From the 22nd to the 36th week, which is called a stillbirth, we investigated 16 cases and determined that in 7 cases the cause was stem villi artery occlusion. During the regular period of still birth which is from the 37th to the 41st week, we investigated 11 cases. In 7 cases the cause was stem villi artery occlusion. Discussion: Approximately 50% of the inflammation involved in late stage abortions could reoccur, so we need to ensure that we treat it before pregnancy. Fatal artery thrombosis is detectable by ultra sonography. To summarize placental examination is essential for both the health of the mother and the child. http://dx.doi.org/10.1016/j.placenta.2013.07.038
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
No.26 PSEUDO-PMD (PLACENTAL MESENCHYMAL DYSPLASIA)
Abstract Masayoshi Arizawa Objectives: Toll-like receptors (TLRs) are found at many sites in human body. They play important roles of the innate immune system. On the other hands, chorioamnionitis (CAM) is thought to be a cause of preterm birth (PTB) and subsequent neonatal adverse effect. It is well known that administration of lipopolysaccharide (LPS) which is recognized by TLR4 leads to preterm birth in animal model, and it supports that TLR4 is associated with CAM and PTB. However, there is little data about other members of TLRs. In this study, we focused on TLR2/5/6 and undertook investigation of the expression of these in the human preterm placenta to reveal the connection between TLRs and CAM. Methods: We extracted the case of PTB in our hospital and provided two groups. Control (¼ CAM (-)) group consisted of woman who had elective caesarian section prior to 37 weeks of gestation without obstetrical complications, CAM (+) group consisted of woman who had PTB and were pathologically diagnosed of CAM. Immunohistochemistry was performed with each TLR antigen on microscopic section of the placental tissues. Immunohistochemical staining was evaluated in each slide. Results: Increased expression of TLRs in amnion and chorion was shown in CAM (+) group. On the other hand, no significant difference between two groups was observed in villi and decidua. Conclusions: This study shows that TLRs expression of fetal membrane was elevated in chorioamnionitis, especially in amnion and chorion. This supports that TLRs pray important roles in human chorioamnionitis and PTB.
Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
Abstract
INVESTIGATING THE CAUSE OF ABORTION AND STILLBIRTH THROUGH PLACENTAL PATHOLOGICAL EXAMINATION
Objections: PMD (Placental Mesenchymal Dysplasia) is a rare condition of placentomegaly, vascular abnormality, grape like vesicle and dilated chorionic vessels. Most PMD are normal female karyotype. PMD are often complicated with IUGR (intrauterine growth restriction), and IUFD (intrauterine fetal death).It is important to distinguish PMD from mole .The differentiation between PMD and mole is whether trophoblast is proliferated or not. Recently, I encountered two cases of vesicle lesion without trophoblast proliferation. Neither of which were PMD case. In this study, I will try to distinguish whether these cases with cystic lesion are PMD, mole or Pseudo-PMD. Material: I examined 1,000 placenta cases over a period of 2 years. I examined more than 4 slides of placenta parenchyma for each case. Results: From the pathological view, I found three cases of cystic lesions without trophoblast proliferation. The first case was published as a PMD with IUFD. The second case is associated with 13trisomy, not only cystic lesion of placenta, but also dysmature villi and villous vessels abnormality. The third case is with cystic lesion and villous ischemia, IUGR, and Pregnancy Induced Hypertension. Conclusions: IUGR and IUFD have a high rate of complication due to PMD, and are well known. Cystic lesions and vascular lesions due to PMD probably come from terminal villi. The cases which I reviewed are not typical PMD, because the second case is based upon 13trysomy vascular abnormality, and the third case is based upon the collapse of ischemic vessels. I have determined that these two cases are Pseudo-PMD. However, I seldom encounter cystic lesion with vascular lesions even though I observe over 100 placental vascular lesions annually. I have coined the phrase “Pseudo-PMD”.
Masayoshi Arizawa
http://dx.doi.org/10.1016/j.placenta.2013.07.039
http://dx.doi.org/10.1016/j.placenta.2013.07.037 No.25
Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
Abstract Purpose: Allow mothers to prepare for future pregnancies by addressing hidden causes of abortion and still birth. I try to find out the cause of death through placental pathology.
No.27 TRIAL OF GRADING FOR VILLITIS OF UNKNOWN ETIOLOGY (VUE) DUE TO PATHOLOGICAL INVESTIGATION Masayoshi Arizawa Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
Abstract Objective: The ocean mammals such as whales, dugong and manatee produce placentation in the uterus, but Manta ray belonging to the family of Elasmobranch does not only produce placentation in the uterus, but only makes densely developed villous strings called trophonemata. Although its morphologic characters have been clarified by histochemical and ultrastructural studies (Soma, 2013), it is, however, still unknown how the fetus could be nourished by trophonemata in the uterus of Manta ray. Methods: 1) The ultrastructural differences between the non-gravid uterus and the gravid uterus of Manta alfredi were compared. 2) Ultrasonic images between the fetal movement and trophonemata in utero of Manta alfredi were visualized by the use of ultrasonar machine in the large water tank of the aquarium. Results: 1) In contrast with proliferation of the endometrial cells in the non-gravid uterus of Manta ray, very densely growth patterns of trophonemata including many secretory granules could be illustrated in the gravid uterus. 2) Using the ultrasonar machine, growth pattern of trophonemata and the fetal growth as well as the uptake ways of respiration and nutrients can be recognized. Conclusions: The development of fetus with trophonemata could be reflected in the gravid uterus of Manta ray. http://dx.doi.org/10.1016/j.placenta.2013.07.033 No.21 ALTERATION OF PROTEASE SYSTEM AND DAMPS ON HUMAN TERM PLACENTAL TROPHOBLAST UNDER HYPOXIC CULTURE Katsuhiko Naruse, Taihei Tsunemi, Natsuki Koike, Akira Onogi, Juria Akasaka, Chiharu Uekuri, Hidekazu Oi, Hiroshi Kobayashi Nara Medical University, Nara, Japan
Abstract Background: MMP (Matrix metalloproteinase) is zinc-required protease and may be involved in the formation and maintenance of human placenta. We reported alteration of the MMP system under hypoxic stimulation in primary human extravillous trophoblast from early gestation (Onogi A, et al. Placenta, 2011). In this study, we examined alterations of proteases and HMGB1, a major molecule in DAMPs (Danger Associated Molecular Patterns), to suggest the effect of placental hypoxia on maternal complications in the 3rd trimester of pregnancy. Methods: Placenta was taken from healthy elective Caesarean section patients. Trophoblasts were separated using trypsin and PercollR, and cultured under 20% oxygen with or without 3 rounds of 0.1% hypoxic stimulation for 1 hour. MMP-2 and TIMP-2 concentrations were measured with multiple cytokine ELISA array, and HMGB1 was measured with ELISA assay. Results: Concentrations of MMP-2 and TIMP-2 in the trophoblast culture supernatant were decreased in hypoxic stimulation compared to normal culture. Significant increase of HMGB1 was observed in hypoxic culture compared to normal culture. Conclusions: MMP-2 and TIMP-2, which known as the protease system dominantly exists in the placenta and uterus were suppressed in hypoxic condition, maybe for the maintenance or proliferation of the placenta. We reported a peripheral increase of HMGB1 in the patient of early onset severe preeclampsia (Naruse K, et al. J Reprod Immunol, 2012). Placental release of HMGB1, the “danger signal” works as a fetal messenger and a
A9
trigger for systemic inflammation may be a key circumstance of fetomaternal conflict in pregnancy. http://dx.doi.org/10.1016/j.placenta.2013.07.034
No.22 A CASE OF PMD WITH THE HIGH MATERNAL SERUM LEVELS OF SFLT-1 Sameshima Azusa 1, Noriko Yoneda 1, Msahito Morijiri 1, Rika Yonezawa 1, Satoshi Yoneda 1, Arihiro Shiozaki 1, Ritsuko K. Pooh 2, Masahiro Nakayama 3, Hidenobu Soejima 4, Shigeru Saito 1 1
Department of Obstetrics and Gynecology, University of Toyama, Japan; CRIFM Clinical Research Institute of Fetal Medicine PMC, Japan; 3 Department of Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan; 4 Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Japan 2
Abstract Placental mesenchymal dysplasia (PMD) is a rare placental anomaly characterized by a hydropic placenta and depicting multiple cysts, and there are few PMD cases complicated with maternal disorder. We have experienced a case of PMD with preeclampsia. A 31-year-old woman (3G0P) suffering from three times miscarriages had been taking low-dose aspirin therapy. Multiple cystic lesions in the placenta were noted on ultrasound examination at 10 weeks of gestation. The maternal serum hCG level was high at 360,000 IU per L, but the karyotype of villus showed a normal 46,XY, suggested a diagnosis of PMD. She was admitted at 20 weeks of gestation because of preclampsia. The fetal growth is normal, but polyhydramnions was observed. On 26 weeks and 0 days of gestation, she complained of increased labor pain, and therefore a cesarean section was performed. The male baby weighed 812g (0.0SD) and Apgar scores were 2 and 7 points at 1 and 5 min. The newborn showed persistent hypoglycemia without macroglassia or hernia of the umbilical cord. Histological examination showed multiple hydropic cysts, stromal hypercellularity and cistern formation in the part of placenta. Vascular anomalies were not observed. The epigenetic analysis of the placenta and cord blood confirmed BWS, because of the loss of methylation at KvDMR1. The maternal serum and cystic fluid of placenta levels of soluble fms-like tyrosine kinase-1 (sFlt-1) were extremely high (88,000 pg per mL and 171,000 pg per mL) compared with those reported in preeclampsia, suggesting an angiogenic imbalance may have caused preeclampsia with severe proteinuria. http://dx.doi.org/10.1016/j.placenta.2013.07.035
No.23 THE EFFECTS OF SYNCYTIN-1, SYNCYTIN-2 AND ASCT2 FOR THE CELL FUSION IN HUMAN PLACENTAL BEWO CELLS Takahiro Nobuzane, Yoshiki Kudo Department of Obstetrics and Gynecology, Hiroshima University, Japan
Abstract Introduction: Syncytin-1 and syncytin-2, the human endogenous retrovirus envelope proteins, are highly expressed in the placenta, and contributes to placental fusion. ASCT2 is a syncytin-1 receptor. The alteration of these gene expressions in pre-eclampsia has been reported. To investigate the effects of syncytin-1, syncytin-2 and ASCT2 for fusion activity, we use siRNA technique in human placental BeWo cells.
A10
Abstracts / Placenta 34 (2013) A1–A17
Methods: BeWo cells was treated with siRNA for each of syncytin-1, syncytin-2 or ASCT2 and both of syncytin-1 and 2, followed by incubation with forskolin to become fusion. The cell-fusion activity was evaluated by flow-cytometry. Results: The mRNA expression of syncytin-1 syncytin-2 and ASCT2 were reduced after incubation of its specific siRNA treatment. The fusion number was reduced only in syncitin-1 specific siRNA treatment group. Discussion: This result suggests that syncytin-1, rather than syncytin-2, has strong effect for cell-fusion in BeWo cells. http://dx.doi.org/10.1016/j.placenta.2013.07.036 No.24 EXPRESSION PLACENTA
OF
TOLL-LIKE
RECEPTORS
IN
HUMAN
PRETERM
Hiroaki Moroi, Takafumi Ushida, Shima Hirakou, Masako Sawada, Tomoko Nakano, Yuka Hattori, Yuriko Watanabe, Yukio Mano, Hiroyuki Tsuda, Seiji Sumigama, Hidenori Takahashi, Tomomi Kotani, Fumitaka Kikkawa
Material: I reexamined 74 cases ; placental and villi. Results: This investigation looked at 50 cases of early abortion which is until the 11th week of pregnancy. Eight of the abortions were due to placental dysmature villi. For the other 4 cases we found that there was a lot of fibrin deposition around the villi. For the late abortion stage which is from the 12th to the 21st weeks of pregnancy, we looked at 34 cases. I determined that in 16 cases, there was a highly inflammatory cell invasion which may have been caused by infection. Another 6 cases showed dysmature villi, which shows that the same issue continues into the 21st week. From the 22nd to the 36th week, which is called a stillbirth, we investigated 16 cases and determined that in 7 cases the cause was stem villi artery occlusion. During the regular period of still birth which is from the 37th to the 41st week, we investigated 11 cases. In 7 cases the cause was stem villi artery occlusion. Discussion: Approximately 50% of the inflammation involved in late stage abortions could reoccur, so we need to ensure that we treat it before pregnancy. Fatal artery thrombosis is detectable by ultra sonography. To summarize placental examination is essential for both the health of the mother and the child. http://dx.doi.org/10.1016/j.placenta.2013.07.038
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
No.26 PSEUDO-PMD (PLACENTAL MESENCHYMAL DYSPLASIA)
Abstract Masayoshi Arizawa Objectives: Toll-like receptors (TLRs) are found at many sites in human body. They play important roles of the innate immune system. On the other hands, chorioamnionitis (CAM) is thought to be a cause of preterm birth (PTB) and subsequent neonatal adverse effect. It is well known that administration of lipopolysaccharide (LPS) which is recognized by TLR4 leads to preterm birth in animal model, and it supports that TLR4 is associated with CAM and PTB. However, there is little data about other members of TLRs. In this study, we focused on TLR2/5/6 and undertook investigation of the expression of these in the human preterm placenta to reveal the connection between TLRs and CAM. Methods: We extracted the case of PTB in our hospital and provided two groups. Control (¼ CAM (-)) group consisted of woman who had elective caesarian section prior to 37 weeks of gestation without obstetrical complications, CAM (+) group consisted of woman who had PTB and were pathologically diagnosed of CAM. Immunohistochemistry was performed with each TLR antigen on microscopic section of the placental tissues. Immunohistochemical staining was evaluated in each slide. Results: Increased expression of TLRs in amnion and chorion was shown in CAM (+) group. On the other hand, no significant difference between two groups was observed in villi and decidua. Conclusions: This study shows that TLRs expression of fetal membrane was elevated in chorioamnionitis, especially in amnion and chorion. This supports that TLRs pray important roles in human chorioamnionitis and PTB.
Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
Abstract
INVESTIGATING THE CAUSE OF ABORTION AND STILLBIRTH THROUGH PLACENTAL PATHOLOGICAL EXAMINATION
Objections: PMD (Placental Mesenchymal Dysplasia) is a rare condition of placentomegaly, vascular abnormality, grape like vesicle and dilated chorionic vessels. Most PMD are normal female karyotype. PMD are often complicated with IUGR (intrauterine growth restriction), and IUFD (intrauterine fetal death).It is important to distinguish PMD from mole .The differentiation between PMD and mole is whether trophoblast is proliferated or not. Recently, I encountered two cases of vesicle lesion without trophoblast proliferation. Neither of which were PMD case. In this study, I will try to distinguish whether these cases with cystic lesion are PMD, mole or Pseudo-PMD. Material: I examined 1,000 placenta cases over a period of 2 years. I examined more than 4 slides of placenta parenchyma for each case. Results: From the pathological view, I found three cases of cystic lesions without trophoblast proliferation. The first case was published as a PMD with IUFD. The second case is associated with 13trisomy, not only cystic lesion of placenta, but also dysmature villi and villous vessels abnormality. The third case is with cystic lesion and villous ischemia, IUGR, and Pregnancy Induced Hypertension. Conclusions: IUGR and IUFD have a high rate of complication due to PMD, and are well known. Cystic lesions and vascular lesions due to PMD probably come from terminal villi. The cases which I reviewed are not typical PMD, because the second case is based upon 13trysomy vascular abnormality, and the third case is based upon the collapse of ischemic vessels. I have determined that these two cases are Pseudo-PMD. However, I seldom encounter cystic lesion with vascular lesions even though I observe over 100 placental vascular lesions annually. I have coined the phrase “Pseudo-PMD”.
Masayoshi Arizawa
http://dx.doi.org/10.1016/j.placenta.2013.07.039
http://dx.doi.org/10.1016/j.placenta.2013.07.037 No.25
Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
Abstract Purpose: Allow mothers to prepare for future pregnancies by addressing hidden causes of abortion and still birth. I try to find out the cause of death through placental pathology.
No.27 TRIAL OF GRADING FOR VILLITIS OF UNKNOWN ETIOLOGY (VUE) DUE TO PATHOLOGICAL INVESTIGATION Masayoshi Arizawa Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan