Placental pathologic lesions with a significant recurrence risk – what not to miss!

Athena Chen, Drucilla J. Roberts

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Here, we review three important placental pathologies with significant clinical implications and recurrence risks. They are, in order of most to least frequently seen, villitis of unknown etiology, chronic histiocytic intervillositis, and massive perivillous fibrin deposition (also known as maternal floor infarction). These entities occur in both preterm and term gestations and are observed more frequently with maternal and obstetric disorders including prior pregnancy loss, hypertension/preeclampsia, and autoimmune disease. They are associated with, and probably the cause of, significant perinatal morbidity and mortality including intrauterine growth restriction, fetal and neonatal demise, and fetal/neonatal neurocompromise (seizures and cerebral palsy). All three entities have high recurrence risks, with recurrence rates ranging from 34 to 100%. The histologic features of villitis of unknown etiology, chronic histiocytic intervillositis, and massive perivillous fibrin deposition are described herein. We discuss the clinical associations and suggest the subsequent clinical and pathological evaluation. Hypotheses as to the biology of these lesions are reviewed.

Original languageEnglish (US)
Pages (from-to)589-601
Number of pages13
JournalAPMIS
Volume126
Issue number7
DOIs
StatePublished - Jul 2018
Externally publishedYes

Keywords

  • Chronic histiocytic intervillositis
  • Massive perivillous fibrin desposition
  • Maternal floor infarct
  • Villitis of unknown etiology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Immunology and Allergy
  • Microbiology (medical)

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