Trophoblast hyperplasia and maternal arterial pressure at term

From the study of the percentage of syncytial sprouts at the basal plate of 176 placentas, 82 of which were from toxemic and hypertensive patients, the following findings clearly emerge: Trophoblastic hyperplasia (cyto- and syncytiotrophoblast) is the most obvious morphologic alteration of the placenta in toxemia of pregnancy. This was observed in 86.6 per cent of the placentas, as estimated by the syncytial sprouting. A syncytial sprouting in about 8 per cent of the villi of placentas of 38 weeks' gestation or more seems to be the limit between normal and pathologic development of the trophoblast. When sprouting is above 8 per cent, the high arterial pressure readings tend to plateau and are not proportional to the increasing number of sprouts. In moderate hypertension without edema or albuminuria there is trophoblastic hyperplasia in 87.2 per cent, therefore determining the morphologic basis to be classified as initial toxemias.