Claudia Vanea

Placenta pathology provides diagnostic insights for understanding pregnancy complications and guides maternal and perinatal care. While placental abnormalities reflect both acute and chronic maternal-fetal health states, the organ’s spatial and temporal heterogeneity poses significant challenges for systematic histological analysis. To date, there has been no analysis of cell populations and their relationship to placental lesions due to the scale of annotations required by expert pathologists. The Histology Analysis Pipeline.PY (HAPPY), previously published by our group, is a hierarchical deep learning approach for quantitative single-cell resolution analysis of H&E slides. Here we apply HAPPY to analyse 130 slides from 62 live full-term pregnancies across healthy controls and four common placental lesion types (infarction, perivillous fibrin, avascular villi, and intervillous thrombosis). We computed cell-type and tissue-structure compositions, established the expected range of healthy variation, and quantified slide-level deviation from this reference using compositional data analysis. Our results reveal significant cellular composition differences between histologically normal and lesioned placentas, including increased extra-villous trophoblasts and leukocytes, coupled with decreases in Hofbauer cells. These changes accompanied distinctive tissue microstructural alterations, particularly increased fibrin deposition and changes to the villous structures. The magnitude of compositional deviation increased with infarction size but not with intervillous thrombosis. Importantly, many differences extend beyond visibly affected areas, indicating organ-wide adaptive responses rather than purely discrete focal pathologies. This quantitative characterisation provides insights into relationships between specific pathologies and placental structure, demonstrating the potential of AI-based methods to enhance conventional histopathological assessment for research and clinical practice.

Accurate placenta pathology assessment is essential for managing maternal and newborn health, but the placenta’s heterogeneity and temporal variability pose challenges for histology analysis. To address this issue, we developed the ‘Histology Analysis Pipeline.PY’ (HAPPY), a deep learning hierarchical method for quantifying the variability of cells and micro-anatomical tissue structures across placenta histology whole slide images. HAPPY differs from patch-based features or segmentation approaches by following an interpretable biological hierarchy, representing cells and cellular communities within tissues at a single-cell resolution across whole slide images. We present a set of quantitative metrics from healthy term placentas as a baseline for future assessments of placenta health and we show how these metrics deviate in placentas with clinically significant placental infarction. HAPPY’s cell and tissue predictions closely replicate those from independent clinical experts and placental biology literature.

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Accurate placenta pathology assessment is essential for managing maternal and newborn health, but the placenta’s heterogeneity and temporal variability pose challenges for histology analysis. To address this issue, we developed the ‘Histology Analysis Pipeline.PY’ (HAPPY), a deep learning hierarchical method for quantifying the variability of cells and micro-anatomical tissue structures across placenta histology whole slide images. HAPPY differs from patch-based features or segmentation approaches by following an interpretable biological hierarchy, representing cells and cellular communities within tissues at a single-cell resolution across whole slide images. We present a set of quantitative metrics from healthy term placentas as a baseline for future assessments of placenta health and we show how these metrics deviate in placentas with clinically significant placental infarction. HAPPY’s cell and tissue predictions closely replicate those from independent clinical experts and placental biology literature.

We introduce a new benchmark dataset, Placenta, for node classification in an underexplored domain: predicting microanatomical tissue structures from cell graphs in placenta histology whole slide images. This problem is uniquely challenging for graph learning for a few reasons. Cell graphs are large (>1 million nodes per image), node features are varied (64-dimensions of 11 types of cells), class labels are imbalanced (9 classes ranging from 0.21% of the data to 40.0%), and cellular communities cluster into heterogeneously distributed tissues of widely varying sizes (from 11 nodes to 44,671 nodes for a single structure). Here, we release a dataset consisting of two cell graphs from two placenta histology images totalling 2,395,747 nodes, 799,745 of which have ground truth labels. We present inductive benchmark results for 7 scalable models and show how the unique qualities of cell graphs can help drive the development of novel graph neural network architectures.

Ethical oversight of AI research is beset by a number of problems. There are numerous ways to tackle these problems, however, they leave full responsibility for ethical reflection in the hands of review boards and committees. In this paper, we propose an alternative solution: the training of ethically responsible AI researchers. We showcase this solution through a case study of a centre for doctoral training and outline how ethics training is structured in the program. We go on to present two second-year students' reflections on their training which demonstrates some of their newly found capabilities as ethically responsible researchers.