Acute atherosis is unique vascular changes of the placenta associated with poor placentation. It is characterized by subendothelial lipid-filled foam cells, fibrinoid necrosis of the arterial wall, perivascular lymphocytic infiltration, and it is histologically similar to early-stage atherosclerosis. Acute atherosis is rare in normal pregnancies, but is frequently observed in non- transformed spiral arteries in abnormal pregnancies, such as preeclampsia, small for gestational age (SGA), fetal death, spontaneous preterm labor and preterm premature rupture of membranes. In preeclampsia, spiral arteries fail to develop physiologic transformation and retain thick walls and a narrow lumen. Failure of physiologic transformation of spiral arteries is believed to be the main cause of uteroplacental ischemia, which can lead to the production of anti-angiogenic factors and induce endothelial dysfunction and eventually predispose the pregnancy to preeclampsia. Acute atherosis is more frequently observed in the spiral arteries of the decidua of the placenta (parietalis or basalis) than in the decidual or myometrial segments of the placental bed. The presence and deeper location of acute atherosis is associated with poorer pregnancy outcomes, more severe disease, earlier onset of preeclampsia, and a greater frequency of SGA neonates in patients with preeclampsia. Moreover, the idea that the presence of acute atherosis in the placenta may increase the risk of future cardiovascular disease in women with a history of preeclampsia is of growing concern. Therefore, placental examination is crucial for retrospective investigation of pregnancy complications and outcomes, and accurate placental pathology based on universal diagnostic criteria in patients with abnormal pregnancies is essential for clinicopathologic correlation.
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It has been suggested that the fish oil can reduce atherogenesis in humans and animals, and that peroxidation of lipoproteins may be a major factor causing atherosclerotic lesions. We tested these posibilities in rabbits fed an atherogenic diet by comparing the effect of a eicosapentaenoic acid(EPA: a major component of fish oil)supplement and a butyrated hydroxyanisole(BHA: antioxidant)diet supplement. Tweenty-eight young male New Zealand White rabbits were used in this study. The animals were divided by control, cholesterol fed only, cholesterol + EPA, and cholesterol + BHA groups. The experimental course lasted 12 weeks and animals were sacrificed periodically(2, 5, 8, 12weeks)for quantitative studies of aortic atherosclerosis using light and electron microscopy. Plasma cholesterol levels were determined and lipopreteins were separated periodically. The cholesterol fed only group showed an increased serum cholseterol level and atherosclerotic lesions from 5 weeks of experiments. The EPA supplement resulted in similiar serum cholesterol levels with cholesterol fed only group, but greater lesion than cholesterol fed only group. The BHA supplement resulted in higher serum cholesterol levels except VLDL-cholesterol than EPA supplement group. However, the atherosclerotic lesion was not increased. Our studies support the theory that oxidative modification of lipoproteins is important for the atherogenesis and antioxidant may have a protective effect.
However, it failed to show antiatherogenesis effect of fish oil.