Diminished Uteroplacental Perfusion
Epidemiology and Etiology:
- Pregnancy induced hypertension
- Pre-eclampsia
- Anticardiolipin
antiobody syndrome
- Systemic lupus
- Lupus anticoagulant
- Scleroderma
- Thrombophilias
- Others
Common sites:
Gross features:
- Infarcts:
- Large. multiple
- Central portion of the placenta
- Infarcts of any size in preterm placentas
- Retroplacental
hematoma
Histologic features:
- Ischemic changes in the villous tissue:
- Infarcts
- Increased number and size of syncytial knots
and/or abnormal configurations (Tenney-Parker
change) (normal at term is ~30% of villi with knots)
- Accelerated villous maturation
- Smaller and increased numbers of villous
capillaries
- More rarified trophoblastic cover than
expected
- Delayed villous maturation
- Larger and more immature than appropriate for
gestational age (diabetes, fetal hydrops)
- Retroplacental
hematoma
- Decidual
changes
- Acute atherosis
- Necrosis of the vascular wall (fibrinoid necrosis most commonly)
- Fibrinoid necrosis – deep
eosinophilia in the walls of the vessels characteristically
- Accumulation of foamy macrophages within the
endothelium / vessel walls
- Decidual vasculopathy (less distinctive
vascular lesions)
Immunophenotype:
Marker:
|
Sensitivity:
|
Specificity:
|
|
|
|
Molecular features:
Other features:
References: