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Placenta, Umbilical Cord, and Amniotic Membranes
Published in Asim Kurjak, CRC Handbook of Ultrasound in Obstetrics and Gynecology, 2019
Macroscopic lesions of the placenta could be divided into three groups: Lesions due to the disturbances of maternal blood flow to or through the placenta: massive perivillous fibrin deposition, subchorionic fibrin deposition, massive subchorial thrombosis, retroplacental hematoma, marginal hematoma, infarct.Lesions due to the disturbances of fetal blood flow: intervillous thrombosis, Kline’s hemorrhage, fetal artery thrombosis, and subamniotic hematoma.Nonvascular lesions: calcifications, septal cyst.
Histological Evaluation of Products of Conception, Who Benefits from It?
Published in Fetal and Pediatric Pathology, 2023
Haleh Soltanghoraee, Arash Mohazzab, Azadeh Soltani, Soheila Ansaripour, Maryam Tavakoli, Maryam Rafati, Amir Hassan Zarnani, Saeed Reza Ghaffari
The systematic approach to placental pathology was presented at the International Federation of Placenta Associations meeting in 2006 [24]. Subsequently a comprehensive system was suggested in Amsterdam in 2014 [17]. Based on the Amsterdam consensus, in the clinical setting of recurrent miscarriage, further diagnostic information regarding the underlying cause of the pregnancy failure may be obtained from examination of products of conception [14,17]. There are three recurrent pathologies with clinical significance: villitis of unknown etiology, massive perivillous fibrin deposition and chronic intervillositis of unknown etiology. Villitis of unknown etiology happens specifically at the third trimester [16], therefore, it was not included in our study. Massive perivillous fibrin deposition/maternal floor infarction is seen generally at the third trimester, while inter/perivillous fibrin deposition is its equivalent pathology in the first trimester; therefore, it has been included in our study.
Combined Placental Maternal Floor Infarction and Cytomegalovirus Placentitis: A Case Report
Published in Fetal and Pediatric Pathology, 2022
Mana Taweevisit, Montakarn Tansatit, Piriya Sutthiruangwong, Noppachai Siranart, Paul Scott Thorner
Maternal floor infarction (MFI) and massive perivillous fibrin deposition (MPFD) are placental disorders of uncertain etiology with a reported frequency of <1% of pregnancies [1–3]. The histologic features of MFI and MPFD are similar; chorionic villi are entrapped by amorphous fibrinoid material with eventual necrosis of syncytiotrophoblast cells and capillary endothelial cells, and persistence of villous outlines and stromal cells [2,3]. In MFI, the fibrinoid accumulation is limited to the basal plate, whereas in MPFD, the accumulation extends throughout the placental substance. However, since the distribution of fibrinoid material is not always spatially distinct, the two conditions are considered to fall within the spectrum of a single pathologic process [1]. MFI/MPFD is associated with adverse perinatal outcome, including stillbirth, preterm delivery, oligohydramnios, fetal growth restriction, renal tubular dysgenesis and neurodevelopmental impairment. The basis for these events involves chronic insufficiency of maternofetal exchange due to obliteration of the intervillous space by fibrinoid material. There is a high risk of recurrence (up to 78%) in subsequent pregnancies [1–3].
Placental Findings Contributing to Perinatal Death: A 15-Year Retrospective Review from a Teaching Hospital in Thailand
Published in Fetal and Pediatric Pathology, 2022
Mana Taweevisit, Paul Scott Thorner
Disorders of other placental processes was the least frequent (3% of the total 208 cases, 6% of placental death cases) category, including maternal floor infarction/massive perivillous fibrin deposition in 3% of cases, compared to 1% reported previously [7,25,33]. The slightly higher occurrence in our study may reflect a lack of uniform diagnostic criteria and/or variations in populations enrolled in each study. The pathogenesis of maternal floor infarction/massive perivillous fibrin deposition is still undetermined, but these disorders are associated with poor pregnancy outcomes, including stillbirth, fetal growth restriction with a high recurrence risk [33–35].