Decidual vascular thrombosis or
Absence or abnormal conversion of decidual vessels or
Fibrinoid necrosis and atherosis of decidual vessels
Can lead to a cessation in blood supply to intervillous space and subsequent collapse of villous architecture and agglutination of villi
Cessation of blood supply to intervillous space and subsequent collapse of villous architecture and agglutination of villi with death of villous trophoblast followed by death of villous stroma and fetal vessels,
Marginal infarcts (<1cm) present in 10% of normal term deliveries
More significant number and size of infacts seen in preclampsia, intrauterine growth retardation, anti-phospholipid antibody syndrome
|General Gross Description|
Acute infarcts (2-3 days old) usually red and firm
Subacute infarct (3-5 days old) usually pink-tan and firm
Old infarcts usually white-tan and firm
Wedge shaped with apex at maternal surface
Can be located marginally or centrally
Can range in size from small to massive
|General Microscopic Description|
Acute infarcts (2-3 days old) show collapse of intervillous space. Villi appear to agglutinate and have lost their outer trophoblast layer, but fetal vasculature can still remain or be degenerating with intervillous hemorrhage.
Old infarcts have virtually no blood in intervillous space and villi have no nuclei whatsoever with pale pink outlines of their shape. These are the so calledd "ghost villi".
Subacte infarcts have microscopic features intermediate between acute and old infarcts
Salafia and Popek "Placenta" (Chaper 69) in Damjanov and Linder (eds) Anderson's Pathology 10th edition, St Louis: Mosby, 1996, p2317.
Cunningham et al Williams Obstetrics, Norwalk: Appleton and Lange, 1993, p742-744.
This link will directly take you to the relevant new literature
||Synopsis by: Linda Ernst (T88100M54700)