Abstract
We aimed to assess fibrin deposition in placentas of patients with preeclampsia (PE) with fetal growth restriction (FGR) and the relationship with fibrinogen-like protein 2 (FGL2). In this case-control study, pregnant women with PE (n=48), PE with FGR (n=44), FGR (n=43), and healthy pregnant women (n=43) at term gestation were recruited. We compared the baseline characteristics, blood coagulation parameters, and placenta characteristics. Masson's trichrome staining was used to categorize 2 types of fibrinoid. FGL2 expression was examined by immunohistochemical staining. The PE+FGR placentas showed more obvious fetal and maternal vascular malperfusion and maternal-fetal interface fibrin deposition when compared with the others. Increased fibrin-type and matrix-type fibrinoids were found in the placenta of the PE+FGR group when compared with the controls. FGL2 was localized in the junction of these 2 types of fibrinoid, as well as extravillous trophoblastic layers and decidual stromal cells. The PE+FGR group had significantly lower FGL2 expression levels. Placental vascular malperfusion with massive maternal-fetal interface fibrin deposition was found in PE with FGR. We report the characteristic colocalization of 2 types of placental fibrinoid deposition and FGL2 immunoreactivity and, therefore, help in elucidating the mechanisms in the pathology of PE with FGR.