Placenta
Placental gross / microscopic abnormalities, nonneoplastic
Fetal thrombotic vasculopathy (FTV)

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

Revised: 12 October 2017, last major update October 2011

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

PubMed Search: "Fetal thrombotic vasculopathy" placenta

Cite this page: Ziadie, M. Fetal thrombotic vasculopathy (FTV). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/placentafetalthrombotic.html. Accessed December 13th, 2017.
Definition / general
  • Thrombosis of fetal vessels results in fibrosis of downstream villi
  • Implies an increased risk for neurologic injury, growth restriction, oligohydramnios and renal / systemic thrombosis (Hum Pathol 1999;30:759)
  • Clinical abnormalities associated with 30%+ avascular villi (Hum Pathol 1995;26:80)
Etiology
  • May be associated with maternal diabetes, hypercoagulable disorders (Hum Pathol 2000;31:1036), maternal diabetes or perinatal liver disease
Gross description
  • Large thrombi of chorionic vessels may be visible
  • Areas of involvement may appear pale and firm
Microscopic (histologic) description
  • Occlusive thrombi in large stem vessels are accompanied by downstream changes including organization, septation, red cell extravasation, endothelial destruction, loss of vascularity and ultimately fibrosis
  • Trophoblastic basement membrane mineralization is common
  • Grading is based on the number of affected villi: focal (3 - 5 avascular villi), intermediate (6 - 19 villi) or large ( > 20 villi)
  • Massive or extensive involvement is defined as 25 - 50% affected parenchyma
  • Changes are similar to those seen in intrauterine fetal demise but are focal rather than diffuse
  • Associated pathologic findings may include meconium staining, villous chorangiosis and infarction