<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is generally considered to be a variant or complication of preeclampsia. It is a life-threatening obstetric complication.</p>
</sec>
<sec><h3>Objectives</h3>
<p>To evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblastand Hoffbauer cells in placental villi of patients with HELLP syndrome.</p>
</sec>
<sec><h3>Methods</h3>
<p>Two groups of patients with a total of 50 full-term human placentas (n = 25 in each group) were assigned as the control (normotensive) and HELLP syndrome. Placental tissue samples were fixed in 10% neutral formalin and paraffin-embedding protocol was performed. We prepared 5 μm sections for histological and immunohistochemical staining. Sections were immunostained with Hoffbauer cell marker CD68. For transmission electron microscopy (TEM), placental tissue samples were fixed in 2.5% buffered glutaraldehyde and then, in 1% osmium tetroxide for routine ultrastructural examinations.</p>
</sec>
<sec><h3>Results</h3>
<p>When the HELLP group fetal placental sections were examined, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles, and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The number of CD68-positive Hoffbauer cells per villus control group sections was 0.23 ± 0.02 and the number of CD68-positive cells per villus in HELLP group placenta sections was 0.83 ± 0.12. The increase in the number of Hoffbauer cells per villus in the HELLP group was significant (<italic>P</italic> &lt; 0.001). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblasts in the HELLP group, and degenerative changes were also observed in the ultrastructure of these cells.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>Pathology of the HELLP syndrome is in relation to CD68-positive placental macrophages.</p>
</sec>
</abstract>

Background
Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is generally considered to be a variant or complication of preeclampsia. It is a life-threatening obstetric complication.

Objectives
To evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblastand Hoffbauer cells in placental villi of patients with HELLP syndrome.

Methods
Two groups of patients with a total of 50 full-term human placentas (n = 25 in each group) were assigned as the control (normotensive) and HELLP syndrome. Placental tissue samples were fixed in 10% neutral formalin and paraffin-embedding protocol was performed. We prepared 5 μm sections for histological and immunohistochemical staining. Sections were immunostained with Hoffbauer cell marker CD68. For transmission electron microscopy (TEM), placental tissue samples were fixed in 2.5% buffered glutaraldehyde and then, in 1% osmium tetroxide for routine ultrastructural examinations.

Results
When the HELLP group fetal placental sections were examined, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles, and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The number of CD68-positive Hoffbauer cells per villus control group sections was 0.23 ± 0.02 and the number of CD68-positive cells per villus in HELLP group placenta sections was 0.83 ± 0.12. The increase in the number of Hoffbauer cells per villus in the HELLP group was significant (P < 0.001). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblasts in the HELLP group, and degenerative changes were also observed in the ultrastructure of these cells.

Conclusions
Pathology of the HELLP syndrome is in relation to CD68-positive placental macrophages.

Severe preeclampsia complicated by HELLP syndrome alters the structure of Hofbauer and syncytiotrophoblast cells: ultrastructural and immunohistochemical study

Department of Histology and Embryology, Faculty of Medicine

Department of Obstetrics and Gynecology, Faculty of Medicine

Department of Microbiology, Atatürk Health High School

Asian Biomedicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is generally considered to be a variant or complication of preeclampsia. It...

Clinical features	Normotensive Median (min–max)	HELLP Median (min–max)
Age	32 (29–35)	32 (30–37)
Gravida	2 (0–4)	4 (2–5)
Parity	1 (0–3)	5 (2–7)
Gestation week	38 (37–39)	38 (38–40)
Systolic BP	95 (88–105)	205 (153–233)
Diastolic BP	75 (65–90)	98 (90–111)
Hemoglobin	13 (12–14)	12 (8–13)
Platelet	265 (135–355)	154 (133–274)
Glucose	88 (70–98)	92 (83–110)
Urea	15 (11–18)	34 (23–52)
Creatinine	0.45 (0.40–0.52)	0.59 (0.51–0.70)
ALT	10 (6–18)	14 (9–60)
AST	19 (10–36)	26 (20–333)
24 h-urine protein	157 (110–195)	1,105 (889–1,245)

Severe preeclampsia complicated by HELLP syndrome alters the structure of Hofbauer and syncytiotrophoblast cells: ultrastructural and immunohistochemical study

Article Category: Brief communication

Published Online: Oct 26, 2023

Page range: 238 - 243

DOI: https://doi.org/10.2478/abm-2023-0065

Keywords
HELLP syndrome, Hoffbauer cell, immunohistochemistry, placenta, syncytiotrophoblast

© 2023 Yusuf Nergiz et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Figure 2.

Figure 3.

Clinical and biochemical parameters of normotensive and HELLP patients

Severe preeclampsia complicated by HELLP syndrome alters the structure of Hofbauer and syncytiotrophoblast cells: ultrastructural and immunohistochemical study

Article Category: Brief communication

Published Online: Oct 26, 2023

Page range: 238 - 243

DOI: https://doi.org/10.2478/abm-2023-0065

KeywordsHELLP syndrome, Hoffbauer cell, immunohistochemistry, placenta, syncytiotrophoblast

© 2023 Yusuf Nergiz et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Figure 2.

Figure 3.

Clinical and biochemical parameters of normotensive and HELLP patients

Keywords
HELLP syndrome, Hoffbauer cell, immunohistochemistry, placenta, syncytiotrophoblast