Placental lesions attributed to shallow implantation, excess extravillous trophoblast and decidual hypoxia: Correlation with maternal vascular malperfusion and related obstetric conditions

Maternal vascular malperfusion (MVM) is one of four main patterns of placental injury defined by the Amsterdam consensus statement and is associated with adverse fetal and maternal outcomes. Laminar decidual necrosis (DLN), extravillous trophoblast islands (ETIs), placental septa (PS), and basal pla...

Full description

Saved in:
Bibliographic Details
Published in:Placenta (Eastbourne) 2023-08, Vol.139, p.61-67
Main Authors: Lechner, Adam C., Slack, Jonathan C., Carreon, Chrystalle Katte, Quade, Bradley J., Parra-Herran, Carlos
Format: Article
Language:English
Subjects:
Decidual laminar necrosis
Female
Humans
Hypertension, Pregnancy-Induced - pathology
Hypoxia - pathology
Maternal vascular malperfusion
Multinucleated trophoblast
Pathology
Placenta
Placenta - pathology
Placental septa
Pre-Eclampsia - pathology
Pregnancy
Trophoblast island
Trophoblasts - pathology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Maternal vascular malperfusion (MVM) is one of four main patterns of placental injury defined by the Amsterdam consensus statement and is associated with adverse fetal and maternal outcomes. Laminar decidual necrosis (DLN), extravillous trophoblast islands (ETIs), placental septa (PS), and basal plate multinucleate implantation-type trophoblasts (MNTs) are lesions attributed to decidual hypoxia, excess trophoblast, and shallow implantation, but are not included in the current MVM diagnostic criteria. We aimed to investigate the relationship between these lesions and MVM. A case-control model was used to evaluate for DLN, ETIs, PS, and MNTs. Placentas with MVM on pathologic examination (defined as ≥2 related lesions) constituted the case group, and maternal age- and GPA-status-matched placentas with less than 2 lesions constituted the control group. MVM-related obstetric morbidities were recorded, including hypertension, preeclampsia, and diabetes. These were correlated with the lesions of interest. 200 placentas were reviewed: 100 MVM cases and 100 controls. MNTs and PS showed significant enrichment in the MVM group (p 2 mm linear extent) were significantly associated with chronic or gestational hypertension (OR = 4.10; p 
ISSN:0143-4004
1532-3102
DOI:10.1016/j.placenta.2023.05.020