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Large placental hemangioma diagnosed by ultrasonography: a case report
Bittencourt, Achiléa Lisboa;Chagas, Kleber;Calabrick, Vania Ayres Teixeira;
Sao Paulo Medical Journal , 1995, DOI: 10.1590/S1516-31801995000600006
Abstract: we present a case of large placental hemangioma comprising more than half of the organ and not causing feto-maternal complications. it appeared after 29 weeks of gestation. at 29 weeks an ultrasonography disclosed a normal placenta. at 35 weeks of gestation it measured 60 x 57 mm and appeared as a well delineated hypoechoic image. delivery took place at 38 weeks by cesarean section and the child was normal.
Can Placental Histopathology Lesions Predict Recurrence of Small for Gestational Age Neonates?
Eran Weiner,Jacob Bar,Letizia Schreiber,Michal Kovo,Michal Levy,Sophia Leytes,Yossi Mizrachi
- , 2018, DOI: 10.1177/1933719117749757
Abstract: To study the role of placental pathology in predicting the recurrence of delivery of small for gestational age (SGA) neonates. The medical records and placental pathological reports of normotensive women who gave birth at 24 to 42 weeks to neonates with birth weight (BW) <10th percentile were reviewed. Patients were divided according to their subsequent pregnancy into those who developed or did not develop recurrent SGA (BW < 10th percentile). The clinical and pathological characteristics of the index pregnancies were compared between the groups. A prediction model was generated for SGA recurrence. The recurrent SGA group (n = 67) was characterized by a higher rate of placental weight <10th percentile (P = .01), and higher neonatal to placental weight ratio (P = .003), as compared to the nonrecurrent SGA group (n = 99). On multivariate logistic regression analysis, placental maternal and fetal vascular malperfusion lesions and higher neonatal to placental weight ratio were all independently associated with recurrent SGA. Birth weight <3rd percentile was the only clinical variable associated with recurrent SGA. A prediction model for recurrent SGA included the following independent risk factors: BW <3rd percentile, villous lesions of maternal vascular malperfusion, and neonatal to placental weight ratio. The presence of placental vascular malperfusion lesions and increased neonatal to placental weight ratio at index pregnancy are associated with recurrent SGA in subsequent pregnancy
Study of the Placenta in the Context of Fetal Pathology Related to COL4A1/A2  [PDF]
Amadou Ndiade, Mame Venus Gueye, Ndiaga Diop
Open Journal of Pathology (OJPathology) , 2026, DOI: 10.4236/ojpathology.2026.162012
Abstract: Introduction: Structural alterations of type IV collagen resulting from genetic mutations or immune-mediated injury disrupt epithelial integrity and lead to organ dysfunction. The α1 (IV) and α2 (IV) chains are key components of type IV collagen within the basement membrane of vascular endothelium. To date, few studies have specifically investigated placental lesions associated with COL4A1/A2-related fetal pathology, and only limited cases describing fetal vascular malperfusion have been reported. Materials and Methods: This study includes ten cases of COL4A1/A2-related fetal pathology collected following a collaborative call issued by the French Society of Fetopathology (SOFFOET). All placentas were re-examined histologically using hematoxylin-eosin-saffron (HES)-stained sections, including systematic evaluation of the umbilical cord, membranes, and a minimum of four placental parenchymal samples per case. Immunohistochemistry using anti-collagen IV antibodies and special histochemical stains (PAS, green trichrome, and orcein) were performed in five cases and in two control cases with hemorrhagic brain pathology without COL4A1/A2 abnormalities. Results: Ten fetuses were included in the study. Dysmorphic features were present in five cases, and congenital malformations in three. All cases showed cerebral ischemic and hemorrhagic lesions. One fetus carried a COL4A2 mutation with a normal COL4A1 gene, whereas the remaining fetuses had COL4A1 mutations. Eight placentas were normotrophic and two hypertrophic, with no hypotrophic placentas identified. Fetal vascular malperfusion lesions were observed in five cases. Discussion: All cases in this series were index cases with no known family history, except for a history of intracranial aneurysms in one case, in which the COL4A1 variant occurred de novo. Endothelial detachment of chorionic and stem villous vessels and vacuolization of the tunica media were observed both in the study cases and in the control, placentas lacking COL4A1/A2 variants, suggesting these findings may be non-specific. Immunohistochemical staining for collagen IV did not reveal overt abnormalities of the endothelial basement membrane, possibly due to acute hypoxic injury related to medical termination of pregnancy.
Association of Maternal Prepregnancy Body Mass Index With Placental Histopathological Characteristics in Uncomplicated Term Pregnancies
Arie Franx,Bas B van Rijn,Laura Brouwers,Michiel L Houben,Peter GJ Nikkels,Tatjana E Vogelvang
- , 2019, DOI: 10.1177/1093526618785838
Abstract: Prepregnancy obesity is a growing global health problem and has several risks for mother and child. The aim of this study was to systematically examine the effect of increased maternal body mass index (BMI) on placental pathology in otherwise uneventful term pregnancies. In this analysis, we studied data of the Netherlands Amniotic Fluid study, a prospective study of women delivering in Utrecht, the Netherlands, between 2006 and 2007. We included women with uncomplicated pregnancies, vaginal delivery, and data on prepregnancy weight and height (n？=？382). Placental histopathology was compared between women of normal BMI (≤24.9？kg/m2), overweight (25–29.9？kg/m2), and obese (≥30？kg/m2). Increasing prepregnancy BMI was associated with heavier placentas and higher mean infant’s birth weight. In addition, obesity was positively associated with high-grade chronic villitis (odds ratio [OR]: 18.1, 95% confidence interval [CI]: 1.6–205.2), accelerated villous maturation (OR: 1.1, 95% CI: 1.0–1.2), and lower incidence of placental weight below the 10th percentile for gestational age (OR: 0.5, 95% CI: 0.3–1.0). There was a substantial effect of parity on maternal, placental, and neonatal weights. Even in uncomplicated pregnancies, maternal obesity is associated with characteristic changes in placental pathology. Further research is needed to evaluate these changes in view of later-life health of infants born to obese mothers
Distinct placental malaria pathology caused by different Plasmodium berghei lines that fail to induce cerebral malaria in the C57BL/6 mouse
Lurdes Rodrigues-Duarte, Luciana Vieira de Moraes, Renato Barboza, Claudio RF Marinho, Blandine Franke-Fayard, Chris J Janse, Carlos Penha-Goncalves
Malaria Journal , 2012, DOI: 10.1186/1475-2875-11-231
Abstract: A mid-term infection protocol was used to test PM induction by three P. berghei parasite lines, derived from the K173, NK65 and ANKA strains of P. berghei that fail to induce experimental cerebral malaria (ECM) in the susceptible C57BL/6 mice. Parasitaemia course, pregnancy outcome and placenta pathology induced by the three parasite lines were compared.The three P. berghei lines were able to evoke severe PM pathology and poor pregnancy outcome features. The results indicate that parasite components required to induce PM are distinct from ECM. Nevertheless, infection with parasites of the ANKAΔpm4 line, which lack expression of plasmepsin 4, displayed milder disease phenotypes associated with a strong innate immune response as compared to infections with NK65 and K173 parasites.Infection of pregnant C57BL/6 females with K173, NK65 and ANKAΔpm4 P. berghei parasites provide experimental systems to identify host molecular components involved in PM pathogenesis mechanisms.
Massive Perivillous Fibrin Deposition of an Enterovirus A
Albert Heim,Gitta Turowski,Henning Feist,Kais Hussein,Thordis Bl？cker
- , 2019, DOI: 10.1177/1093526618798772
Abstract: Massive perivillous fibrin deposition (MFD) is a morphologically defined severe placental lesion associated with perinatal morbidity and mortality. The etiology is unknown, and recurrence risk in subsequent pregnancies is assumed to be high. In most cases, a pathologic immune reaction is supposed to be responsible for the lesion. We report a case of a pregnant woman’s suffering from hand, foot, and mouth disease in the 20th gestational week. Subsequently, MFD developed in the placenta and was followed by intrauterine growth restriction and stillbirth in the 29th gestational week. Enterovirus A with high homology to Coxsackievirus A16 was detected in the placenta by means of immunohistochemisty and reverse transcription polymerase chain reaction. This infection could be a rare cause of MFD and should be taken into consideration in the differential diagnosis of the individual etiology. Recurrence risk of virus-related MFD is expected to be lower than in MFD without infectious association
Placental Histopathology Differences and Neonatal Outcome in Dichorionic–Diamniotic as Compared to Monochorionic–Diamniotic Twin Pregnancies
Ann Dekalo,Elad Barber,Eran Weiner,Jacob Bar,Letizia Schreiber,Michal Kovo,Ohad Feldstein
- , 2018, DOI: 10.1177/1933719117732163
Abstract: We aimed to compare the differences in placental histopathology lesions and pregnancy outcome in dichorionic–diamniotic (DCDA) versus uncomplicated monochorionic–diamniotic (MCDA) twin gestations. Maternal characteristics, neonatal outcome, and placental histopathology reports of all twin deliveries between 24 and 41 weeks were reviewed. Excluded were pregnancies complicated by twin-to-twin transfusion syndrome, twin anemia–polycythemia sequence, selective intrauterine growth restriction, placenta previa, intrauterine fetal death, and malformation. Placental lesions were classified to maternal/fetal vascular malperfusion lesions. Umbilical cord abnormalities included hypo-/hypercoiling and abnormal insertion. Composite adverse neonatal outcome was defined as 1 or more early complications. Small for gestational age (SGA) was defined as birth weight ≤10th percentile. The DCDA group (n = 362) was characterized by higher rates of assisted reproductive techniques (P < .001) and nulliparity (P = .03) as compared to the MCDA group (n = 65). Gestational age at delivery was similar between groups. Placental maternal vascular malperfusion lesions were more common in placentas from DCDA group (38.2% vs 23.1%; P = .016), while fetal vascular malperfusion lesions and abnormal cord insertion were more common in placentas from MCDA group (P = .027; P< .001). The SGA and composite adverse neonatal outcome were more common in the MCDA group (P = .031 and P = .038, respectively). By multivariate regression analysis, composite adverse neonatal outcome was found to be independently associated with the MCDA group, adjusted odds ratio (aOR) = 1.2, 95% confidence interval (CI) = 1.04 to 1.89, P = .041, and with placental fetal malperfusion lesions aOR = 1.3, 95% CI = 1.1 to 2.09, P = .038. Placental pathology differs between MCDA and DCDA twin pregnancies. Adverse neonatal outcome in uncomplicated MCDA twins, as compared to DCDA twins, could be related to increased placental fetal malperfusion lesions and abnormal cord insertion
Placental pathology in birth weight discordant monochorionic and dichorionic twins
- , 2016, DOI: 10.4038/jdp.v11i1.7690
Abstract: Department of Pathology, Faculty of Medicine MBBS, Dpath, M
Unpredictable Placental Abruption: Case Series  [PDF]
Nguyen Hong Hoa, Nguyen Thi Mong Tuyen
Case Reports in Clinical Medicine (CRCM) , 2020, DOI: 10.4236/crcm.2020.96024
Abstract: Background: The diagnosis of placental abruption is primarily clinical, but findings from imaging, laboratory, and postpartum pathologic studies can be used to support the clinical diagnosis. In patients with classic symptoms, fetal heart rate abnormalities, intrauterine fetal demise, and/or disseminated intravascular coagulation strongly support the clinical diagnosis and indicate extensive placental separation. In a few cases, placental separation has not been recognized and was only identified upon cesarean section as an incidental finding. Objectives: To describe the clinical presentations and pregnancy outcomes of placental abruption cases that are not diagnosed before cesarean delivery, termed “unpredictable placental abruption” and also cases diagnosed before cesarean delivery, termed “predictable placental abruption”. Methods: A retrospective analysis of 100 cases of placental abruption was identified by cesarean delivery at Tu Du hospital from September 2018 to May 2019. Clinical variables were compared between the unpredictable and predictable groups. The unpredictable group consists of cases that are not diagnosed before cesarean delivery, while the predictable cases were identified placental separation before cesarean delivery. The maternal and fetal outcomes were also studied. Results: In 100 cases of placental, abruption by gross clinical examination of the placenta at the time operation revealed that, 33% were unpredictable. Placental abruption attributed to maternal complications included one case of total hysterectomy (1%) with no cases of disseminated intravascular coagulation (DIC), shock or maternal death; specifically, this case of total hysterectomy appeared with predictable one. There were two cases of stillbirths. Among the 98 live neonates, 15 cases (14.7%) experienced severe birth asphyxia resulting in eight neonatal deaths; two of which were caused by heart disease and necrotizing enterocolitis. Sixty-three neonates were delivered prematurely (61.74%), with mean gestational age of 34.64 ± 3.32 weeks. Among the 33 unpredictable cases, there were no stillbirths but 60.6% and 12.1% experienced moderate and severe asphyxia, respectively. All unpredictable cases had obvious indications of cesarean section but the basic symptoms and signs of acute placental abruption included the onset of preterm labor, unspecified intrapartum hemorrhage, hypertonic uterine contractions and fetal distress for emergency caesarian section; however there were also
Polyglucosan Bodies in Placental Extravillious Trophoblast for the Diagnosis of Fatal Perinatal Neuromuscular
James R Wright,Marie-Anne Brundler,Weiming Yu
- , 2018, DOI: 10.1177/1093526617707852
Abstract: The fatal infantile neuromuscular type is the most severe form of glycogen storage disease type IV (GSD IV). We report a case of a 22-day-old female neonate born at 34 weeks gestation with polyhyramnios, fetal hydrops, and severe hypotonia. Placental examination revealed numerous periodic acid schiff-positive diastase-resistant polyglucosan bodies in the cytoplasm of extravillous trophoblast predominantly in the placental basal plate. Muscle biopsy and autopsy findings supported a diagnosis of neuromuscular-type glycogen storage disease type IV with extensive involvement of skeletal muscle, heart, and liver. The diagnosis was confirmed by molecular genetic testing. We could only find 1 prior report in the English literature that describes placental pathological changes. Our findings suggest that placental examination can be a useful adjunct for early diagnosis, as placentas are often received for pathological examination shortly after birth and usually before a diagnostic muscle biopsy can be performed. Pathologists need to be aware of characteristic placental features
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