Placental gross/microscopic abnormalities, non-neoplastic
Reviewers: Mandolin Ziadie, M.D. (see Reviewers page)
Revised: 10 October 2011, last major update October 2011
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● Abnormal / incomplete remodeling of the spiral arteries resulting in necrosis (atherosis)
● Observed in placentas from pre-eclamptic pregnancies as well as several collagen-vascular / autoimmune disorders and in those with evidence of growth restriction (Arch Pathol Lab Med 1991;115:722)
● Associated with oxidative stress and endothelial dysfunction
● Placentas may be grossly unremarkable or may be small for gestational age
● Lesions vary from non-necrotic, non-transformed decidual arterioles to early fibrinoid necrosis of vessel walls and late atherosis (fibrinoid necrosis with subendothelial lipid-laden macrophages)
● Thrombi may be present
● Some cases show marked hypertrophy of the media (hypertrophic decidual vasculopathy)
Contributed by Dr. Yan Lemeshev, Texas (USA):
Atherosis with fibrinoid necrosis of vessel walls and lipid laden subendothelial macrophages
End of Placenta > Placental gross/microscopic abnormalities, non-neoplastic > Decidual vasculopathy
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