Nonneoplastic placental conditions and abnormalities
Decidual vasculopathy

Topic Completed: 1 October 2011

Minor changes: 29 October 2020

Copyright: 2002-2020,, Inc.

PubMed Search: "Decidual vasculopathy"

Mandolin S. Ziadie, M.D.
Page views in 2019: 3,000
Page views in 2020 to date: 3,252
Cite this page: Ziadie MS. Decidual vasculopathy. website. Accessed November 30th, 2020.
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

Contributed by Yan Lemeshev, M.D.

Atherosis with fibrinoid necrosis

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