Stereological Changes of Human Placenta in Systemic Lupus Erythematosus Compared with Healthy Controls

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can cause changes in the placenta. In this study, quantitative changes of placenta were investigated using stereological methods. Materials and Methods: In this case-control study, 10 placentas from systemic lupus erythematosus pregnancy (antinuclear antibody > 10), and 10 placentas from normal uncomplicated pregnancy were obtained from Imam Ali Hospital. Volume of placentas was estimated using Cavalieriʹs principle. 3 full-thickness columns of each placenta were taken using systematic uniform random sampling (SURS). After fixation in modified Lillieʹs solution, they were cut into 5 mm slices. 5-7 sections selected from each slice using SURS and stained by Masson’s trichrome. Then stereological analyses were done on 8-10 SURS fields of each section. Placental volume, absolute volume and volume density of chorionic villi, intervillous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. The Mann Whitney-U test was employed to determine statistically significant differences between the means. Significant level was set at p < 0.05. Results: Total volume and volume density of fibrin and total volume and volume density of blood vessels significantly increased in SLE group in comparison with control group (p < 0.01). Volume density of syncytiotrophoblast increased 50% in SLE group in comparison with control group, this increase was statistically significant (p < 0.01). Conclusion: Results showed that systemic lupus erythematosus disease can cause significant changes in the structure of placenta that may be influential on the evolution and survival of fetus.