Plasmodium Falciparum Associated Placental Pathology: A Light and Electron Microscopic and Immunohistologic Study

Minoru YamadaCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by Minoru Yamada in
Current site
Google Scholar
PubMed
Close
,
Richard SteketeeCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by Richard Steketee in
Current site
Google Scholar
PubMed
Close
,
Carlos AbramowskyCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by Carlos Abramowsky in
Current site
Google Scholar
PubMed
Close
,
Masatoshi KidaCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by Masatoshi Kida in
Current site
Google Scholar
PubMed
Close
,
Jack WirimaCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by Jack Wirima in
Current site
Google Scholar
PubMed
Close
,
David HeymannCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by David Heymann in
Current site
Google Scholar
PubMed
Close
,
John RabbegeCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by John Rabbege in
Current site
Google Scholar
PubMed
Close
,
Joel BremanCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by Joel Breman in
Current site
Google Scholar
PubMed
Close
, and
Masamichi AikawaCase Western Reserve University, Centers for Disease Control, Ministry of Health, Cleveland, Ohio, Georgia

Search for other papers by Masamichi Aikawa in
Current site
Google Scholar
PubMed
Close
Restricted access

Pathological changes were studied by light and electron microscopy on term placentas collected in Malawi from 20 P. falciparum infected women (11 primiparas and 9 multiparas). One placenta from an uninfected term primipara and 4 from multiparas were studied as controls. Changes included the presence of parasitized erythrocytes and malarial pigment particles in the intervillous space, excessive syncytial knotting, chronic basal villitis, malarial pigment deposits in the trophoblasts, trophoblastic damage with focal necrosis, partial loss of microvilli, and thickening of the trophoblastic basement membrane. Infected erythrocytes were not seen in the fetal circulation. Severity appeared to correlate with the level of maternal and placental parasitemias, regardless of infant birth weight or placental weight. Differences in the severity of pathological changes between primiparas and multiparas could not be demonstrated. Immunohistochemistry revealed that 45% of the placentas stained strongly for IgG and 15% stained for C3 and for P. falciparum antigens in the trophoblastic cytoplasm and basement membrane.

Save