The frequency and type of placental histologic lesions in term pregnancies with normal outcome

Roberto Romero, Yeon Mee Kim, Percy Pacora, Chong Jai Kim, Neta Benshalom-Tirosh, Sunil Jaiman, Gaurav Bhatti, Jung Sun Kim, Faisal Qureshi, Suzanne M. Jacques, Eun Jung Jung, Lami Yeo, Bogdan Panaitescu, Eli Maymon, Sonia S. Hassan, Chaur Dong Hsu, Offer Erez

Research output: Contribution to journalReview articlepeer-review

73 Scopus citations

Abstract

To determine the frequency and type of histopathologic lesions in placentas delivered by women with a normal pregnancy outcome. This retrospective cohort study included placental samples from 944 women with a singleton gestation who delivered at term without obstetrical complications. Placental lesions were classified into the following four categories as defined by the Society for Pediatric Pathology and by our unit: (1) acute placental inflammation, (2) chronic placental inflammation, (3) maternal vascular malperfusion and (4) fetal vascular malperfusion. (1) Seventy-eight percent of the placentas had lesions consistent with inflammatory or vascular lesions; (2) acute inflammatory lesions were the most prevalent, observed in 42.3% of the placentas, but only 1.0% of the lesions were severe; (3) acute inflammatory lesions were more common in the placentas of women with labor than in those without labor; (4) chronic inflammatory lesions of the placenta were present in 29.9%; and (5) maternal and fetal vascular lesions of malperfusion were detected in 35.7% and 19.7%, respectively. Two or more lesions with maternal or fetal vascular features consistent with malperfusion (high-burden lesions) were present in 7.4% and 0.7%, respectively. Most placentas had lesions consistent with inflammatory or vascular lesions, but severe and/or high-burden lesions were infrequent. Mild placental lesions may be interpreted either as acute changes associated with parturition or as representative of a subclinical pathological process (intra-amniotic infection or sterile intra-amniotic inflammation) that did not affect the clinical course of pregnancy.

Original languageEnglish (US)
Pages (from-to)613-630
Number of pages18
JournalJournal of Perinatal Medicine
Volume46
Issue number6
DOIs
StatePublished - Aug 28 2018
Externally publishedYes

Keywords

  • Acute histologic chorioamnionitis
  • amniotic fluid infection
  • chronic chorioamnionitis
  • chronic deciduitis
  • chronic placental inflammation
  • fetal vascular malperfusion
  • funisitis
  • intra-amniotic infection
  • maternal vascular malperfusion
  • normal or uncomplicated pregnancy
  • sterile intra-amniotic inflammation
  • villitis of unknown etiology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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