Morphological and histological aspects of placentas from women diagnosed with cancer during pregnancy. Evaluation of the effects of tumor growth and exposure to chemotherapy treatment during pregnancy

Abstract

Introduction: The prevalence of cancer among pregnant women has increased significantly over the years, given the advanced maternal age, therapeutic improvements, and fertility preservation. Yet, this event poses a major scientific challenge to deliver better treatments as the placental changes due to cancer are still poorly studied despite the high incidence of complications such as preterm birth and fetal growth restriction. Therefore, elucidating the evolutions during neoplastic disease is necessary to help provide more suitable therapeutic approaches in the future.Objectives: Identify the morphological and histological alterations in the placenta of patients with cancer undergoing treatment (active disease) during pregnancy and chemotherapy treatment.Materials and Methods: We will evaluate the placentas of patients with breast cancer during pregnancy followed by chemotherapy treatment (case study) and the placentas of patients with healthy pregnancies (control group) in partnership with the maternity ward of Prof. Dr. José Aristodemo Pinotti Women's Hospital - Caism/Unicamp. The placentas will be measured (area, volume, and weight) and have both maternal and fetal sides photographed. After this documentation, tissue sections of the basal plate, chorionic villi, chorionic plate, and basal membrane will be fixed in 4% formalin, embedded in paraffin, and cut at a thickness of 4¼m. The sections will be stained with hematoxylin and eosin to evaluate the histological appearance of placental cells from different collected regions. For data analysis, Student's t-test will be used for continuous variables with a normal distribution, comparing the two experimental groups, and the non-parametric Mann-Whitney test will be used due to the small sample size.