Placental gross / microscopic abnormalities, nonneoplastic
Decidual vasculopathy

Topic Completed: 1 October 2011

Minor changes: 18 February 2019

Copyright: 2002-2019,, Inc.

PubMed Search: "Decidual vasculopathy"

Mandolin S. Ziadie, M.D.
Page views in 2019: 3,000
Page views in 2020 to date: 1,382
Cite this page: Ziadie MS. Decidual vasculopathy. website. Accessed May 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 Dr. Yan Lemeshev, Texas (USA)

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

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