Placental gross / microscopic abnormalities, nonneoplastic
Decidual vasculopathy

Author: Mandolin Ziadie, M.D. (see Authors page)

Revised: 12 October 2017, last major update October 2011

Copyright: (c) 2002-2017,, Inc.

PubMed Search: "Decidual vasculopathy"

Cite this page: Ziadie, M. Decidual vasculopathy. website. Accessed October 22nd, 2018.
Definition / general
  • Abnormal / incomplete remodeling of the spiral arteries resulting in necrosis (atherosis)
  • Observed in placentas from preeclamptic 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
Gross description
  • Placentas may be grossly unremarkable or may be small for gestational age
Microscopic (histologic) description
  • Lesions vary from nonnecrotic, nontransformed 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)
Microscopic (histologic) images

Images hosted on PathOut server:

Images contributed by Dr. Yan Lemeshev, Texas (USA):

Atherosis with fibrinoid necrosis of vessel walls and lipid laden subendothelial macrophages