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Overview of Placenta Pathology

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Gynecologic and Obstetric Pathology, Volume 2

Abstract

The placenta is a very common, but often underappreciated, surgical pathology specimen. Gross examination of the placenta should be organized and routine, in order to efficiently identify abnormalities; only a proper gross examination will allow appropriate diagnosis. Gross findings and lesions discussed here include those of the umbilical cord (length, knots, coiling, insertion), membranes (discoloration, plaques, insertion), and disc (size, infarcts, abnormal shapes). The histologic findings are also discussed by site: cord (inflammation, thrombosis, remnants), membranes (pigment, lesions, chorionicity of twins, maternal arteriopathy), and disc (villous maturity, infarcts, hydropic change, villitis, specific infections). Finally, there is a discussion of the unifying diagnoses: maternal vascular malperfusion, fetal vascular malperfusion, and amniotic fluid infection sequence.

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References

  1. Norwitz ER, Schust DJ, Fished SJ. Implantation and the survival of early pregnancy. N Engl J Med. 2001;345:1400–8.

    Article  CAS  Google Scholar 

  2. Kaplan CG. Gross pathology of the placenta: weight, shape, size, colour. J Clin Pathol. 2008;61:1285–95.

    Article  CAS  Google Scholar 

  3. Schneider H. Oxygenation of the placental-fetal unit in humans. Respir Physiol Neurobiol. 2011;178:51–8.

    Article  Google Scholar 

  4. Longtine MS, Nelson DM. Placental dysfunction and fetal programming: the importance of placental size, shape, histopathology, and molecular composition. Semin Reprod Med. 2011;29:187–96.

    Article  Google Scholar 

  5. Nagi AN. A monograph placental examination and pathology. Biomedica. 2017;27:81–99.

    Google Scholar 

  6. Redline RW. Placental pathology: a systematic approach with clinical correlations. Placenta. 2008;29:86–91.

    Article  Google Scholar 

  7. Salafia CM, Yampolsky M, Misra DP, Slakhter O, Haas D, Eucker B, Thorp J. Placental surface shape, function, and effects of maternal and fetal vascular pathology. Placenta. 2010;31:958–62.

    Article  CAS  Google Scholar 

  8. Garrod A, Batra G, Ptacek I, Heazell AEP. Duration and methods of tissue storage alters placental morphology-implications for clinical and research practice. Placenta. 2013;34:1116–9.

    Article  CAS  Google Scholar 

  9. Salafia CM, Yampolsky M, Shlakhter A, Mandel DH, Schwartz N. Variety in placental shape: when does it originate? Placenta. 2012;33:164–70.

    Article  CAS  Google Scholar 

  10. Redline RW. Classification of placental lesions. Am J Obstet Gynecol. 2015;213:S21–S8.

    Article  Google Scholar 

  11. Almog B, Sehata F, Aljabri S, Levin I, SHalom-Paz E, Shrim A. Placenta weight percentile curves for singleton and twins deliveries. Placenta. 2011;32:58–62.

    Article  CAS  Google Scholar 

  12. Baergen RN. Umbilical cord pathology. Surg Pathol Clin. 2013;6:61–85.

    Article  Google Scholar 

  13. Benirschke K, Burton GJ, Baergen RN. Anatomy and pathology of the umbilical cord. In: Pathology of the human placenta. Berlin, Heidelberg: Springer; 2012. p. 309–75.

    Chapter  Google Scholar 

  14. Pathak S, Hook E, Hackett G, Murdoch E, Sebire NJ, Jessop F, Lees C. Cord coiling, umbilical cord insertion and placental shape in an unselected cohort delivering at term: relationship with common obstetric outcomes. Placenta. 2010;31:963–8.

    Article  CAS  Google Scholar 

  15. Redline RW. Inflammatory responses in the placenta and umbilical cord. Semin Fetal Neonatal Med. 2006;11:296–301.

    Article  Google Scholar 

  16. Ernst LM, Minturn L, Huang MH, Curry E, Su EJ. Gross patterns of umbilical cord coiling: correlations with placental histology and stillbirth. Placenta. 2013;34:583–8.

    Article  CAS  Google Scholar 

  17. Patil NS, Kulkarni SR, Lohitashwa R. Umbilical cord coiling index and perinatal outcome. J Clin Diagn Res. 2013;7:1675–7.

    PubMed  PubMed Central  Google Scholar 

  18. Bombrys AE, Neiger R, Hawkins S, Sonek J, Croom C, McKenna D, Ventolini G, Habli HH, Sibai B. Pregnancy outcome in isolated single umbilical artery. Am J Perinatol. 2008;25:239–42.

    Article  Google Scholar 

  19. Hua M, Odibo AO, Macones GA, Roehl KA, Crane JP, Cahill AG. Single umbilical artery and its associated findings. Obstet Gynecol. 2010;115:930–4.

    Article  Google Scholar 

  20. Murphy-Kaulbeck L, Dodds L, Joseph KS, Van den Hof M. Single umbilical artery risk factors and pregnancy outcomes. Obstet Gynecol. 2010;116:843–50.

    Article  Google Scholar 

  21. Goldfarb CA, Sathienkijkanchai A, Robin NH. Amniotic constriction band: a multidisciplinary assessment of etiology and clinical presentation. JBJS. 2009;91:68–75.

    Article  Google Scholar 

  22. Herva R, Karkinen-Jaaskelainen M. Amniotic adhesion malformation syndrome: fetal and placental pathology. Clin Ter. 1984;29:11–9.

    CAS  Google Scholar 

  23. Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler MA, Derricott H, Evans MJ, Faye-Petersen OM, Gillan JE, Heazell AE. Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med. 2016;140:698–713.

    Article  Google Scholar 

  24. Ogino S, Redline RW. Villous capillary lesions of the placenta: distinctions between chorangioma, chorangiomatosis, and chorangiosis. Hum Pathol. 2000;31:945–54.

    Article  CAS  Google Scholar 

  25. De Paepe ME. Examination of the Twin Placenta. Semin Perinatol. 2015;39:27–35.

    Article  Google Scholar 

  26. Hubinont C, Lewi L, Bernard P, Marbaix E, Debieve F, Jauniaux E. Anomalies of the placenta and umbilical cord in twin gestations. Am J Obstet Gynecol. 2015;213:S91–S102.

    Article  Google Scholar 

  27. Avagilano L, Marconi AM, Candiani M, Barbera A, Bulfamante G. Thrombosis of the umbilical vessels revisited. An observational study of 317 consecutive autopsies at a single institution. Hum Pathol. 2010;41:971–9.

    Article  Google Scholar 

  28. Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am J Obstet Gynecol. 2015;213:S29–52.

    Article  Google Scholar 

  29. Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376:717–29.

    Article  Google Scholar 

  30. Parveen Z, Tongson-Ignacio JE, Fraser CR, Killeen JL, Thompson KS. Placental mesenchymal dysplasia. Arch Pathol Lab Med. 2007;131:131–7.

    PubMed  Google Scholar 

  31. Heider A. Fetal vascular malperfusion. Arch Pathol Lab Med. 2017;14:1484–9.

    Article  Google Scholar 

  32. Hood IC, Desa DJ, Whyte RK. The inflammatory response in candidal chorioamnionitis. Hum Pathol. 1983;14:984–90.

    Article  CAS  Google Scholar 

  33. Schwartz DA, Reef S. Candida albicans placentitis and funisitis: early diagnosis of congenital candidemia by histopathologic examination of umbilical cord vessels. Pediatr Infect Dis J. 1990;9:661–5.

    Article  CAS  Google Scholar 

  34. Chou D, Ma Y, Zhang J, McGrath C, Parry S. Cytomegalovirus infection of trophoblast cells elicits an inflammatory response: a possible mechanism of placental dysfunction. Am J Obstet Gynecol. 2006;194:535–41.

    Article  CAS  Google Scholar 

  35. McDonagh S, Maidi E, Chang HT, Pereira L. Patterns of human cytomegalovirus infection in term placentas: a preliminary analysis. J Clin Virol. 2006;35:210–5.

    Article  CAS  Google Scholar 

  36. Finger-Jardim F, Teixeira LO, de Oliveira GR, Barral MF, da Hora VP, Gonalves CV, Soares MA, de Martinez AM. Herpes simplex virus: prevalence in placental tissue and incidence in neonatal cord blood. J Med Virol. 2014;86:519–24.

    Article  Google Scholar 

  37. Heifetz SA, Bauman M. Necrotizing funisitis and herpes simplex infection of placental and decidual tissues: study of four cases. Hum Pathol. 1994;25:715–22.

    Article  CAS  Google Scholar 

  38. Seffield JS, Sanchez PJ, Wendel GD, Fong DW, Margraf LR, Zeray F, McIntire DD, Rogers BB. Placental histopathology of congenital syphilis. Obstet Gynecol. 2002;100:126–33.

    Google Scholar 

  39. Rosenberg AZ, Yu W, Hill DA, Reyes CA, Schwartz DA. Placental pathology of Zika virus: viral infection of the placenta induces villous stromal macrophage (Hofbauer cell) Proliferation and Hyperplasia. Arch Pathol Lab Med. 2017;141:43–8.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    John Paul B. Govindavari & Anna R. Laury

Authors
  1. John Paul B. Govindavari
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  2. Anna R. Laury
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Corresponding author

Correspondence to Anna R. Laury .

Editor information

Editors and Affiliations

  1. Department of Pathology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Wenxin Zheng

  2. Department of Pathology, University of California San Diego, San Diego, CA, USA

    Oluwole Fadare

  3. Department of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Charles Matthew Quick

  4. Department of Pathology, Peking University People’s Hospital, Beijing, China

    Danhua Shen

  5. Department of Obstetrics and Gynecology, Tianjin Gynecologic and Obstetrics Central Hospital, Tianjin, China

    Donghui Guo

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Govindavari, J.P.B., Laury, A.R. (2019). Overview of Placenta Pathology. In: Zheng, W., Fadare, O., Quick, C., Shen, D., Guo, D. (eds) Gynecologic and Obstetric Pathology, Volume 2. Springer, Singapore. https://doi.org/10.1007/978-981-13-3019-3_14

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  • DOI: https://doi.org/10.1007/978-981-13-3019-3_14

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-3018-6

  • Online ISBN: 978-981-13-3019-3

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