{
    "abstract": "Globally, at least 10\u00a0% of maternal deaths, caused by obstetric complications during pregnancy, are linked to preeclampsia or eclampsia. Preeclampsia-induced placental hypoxia leads to vascular injury and syncytial knot formation in terminal villi. Early delivery of preeclampsia placentas complicates comparisons with normotensive term placentas, while the placenta's non-planar structure limits the effectiveness of 2D histology for vascular analysis. This study used multiphoton microscopy to quantify 3D morphological differences in terminal villi between late-onset preeclampsia and control pregnancies. 7 late-onset preeclampsia (Gestational age: 37.3\u00a0weeks) and 10 control (Gestational age: 38.3\u00a0weeks) placentas were stained for nuclei and vasculature, optically cleared using ethyl-cinnamate, imaged with multiphoton microscopy, and analysed semi-automatically. Image quantification revealed a 42\u00a0% decrease in vascular fraction and a 97\u00a0% increase in syncytial knot density in late-onset preeclampsia samples, both statistically significant. No differences were observed in surface area-to-volume ratios, individual syncytial knot volume, or microvascular characteristics, including branchpoint density, vessel length, branching angle, straightness, and diameter. By analysing placentas at comparable gestational ages, we demonstrated that late-onset preeclampsia is characterized by decreased vascular content and increased syncytial knot density, while individual syncytial knot size and microvascular architecture remain unchanged. These findings enhance our understanding of late-onset preeclampsia pathophysiology and could provide a basis to distinguish late-onset preeclampsia from other phenotypes, such as early-onset preeclampsia, highlighting potential differences in disease mechanisms.",
    "authors": [
        {
            "affiliation": "Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands; CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands.",
            "firstname": "Juul",
            "initials": "J",
            "lastname": "Bierens"
        },
        {
            "affiliation": "Department of Pathology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands.",
            "firstname": "Carmen",
            "initials": "C",
            "lastname": "Severens-Rijvers"
        },
        {
            "affiliation": "Department of Cognitive Neuroscience, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, the Netherlands.",
            "firstname": "Sven",
            "initials": "S",
            "lastname": "Hildebrand"
        },
        {
            "affiliation": "Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Institute for Molecular Cardiovascular Research IMCAR, University Hospital RWTH Aachen, Germany; MHeNS School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands.",
            "firstname": "Marc",
            "initials": "M",
            "lastname": "van Zandvoort"
        },
        {
            "affiliation": "GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Obstetrics and Gynaecology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands.",
            "firstname": "Salwan",
            "initials": "S",
            "lastname": "Al-Nasiry"
        },
        {
            "affiliation": "Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Interdisciplinary Centre for Clinical Research IZKF, University Hospital RWTH Aachen 52074 Aachen, Germany. Electronic address: d.kapsokalyvas@maastrichtuniversity.nl.",
            "firstname": "Dimitrios",
            "initials": "D",
            "lastname": "Kapsokalyvas"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 The Authors. Published by Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.ejogrb.2025.03.015",
    "journal": "European journal of obstetrics, gynecology, and reproductive biology",
    "keywords": [
        "Multiphoton microscopy",
        "Optical tissue clearing",
        "Placental villi",
        "Preeclampsia",
        "Syncytial knots",
        "Vasculature"
    ],
    "methods": null,
    "publication_date": "2025-03-13",
    "pubmed_id": "40073755",
    "results": null,
    "title": "Imaging and quantification of placental terminal villi microvasculature and nuclear characteristics in preeclampsia.",
    "xml": "<Element 'PubmedArticle' at 0x788503134a90>"
}