Placental gross / microscopic abnormalities, nonneoplastic

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

Revised: 13 October 2017, last major update October 2011

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

PubMed Search: Infarct of the placenta [title]

Cite this page: Ziadie, M. Infarct. website. Accessed October 22nd, 2018.
Definition / general
  • Villous necrosis secondary to local obstruction of maternal uteroplacental circulation
  • Due to extensive placental reserve, small infarcts and those at the margin are usually clinically insignificant
  • Need > 30% placental involvement to affect fetal income (neonatal asphyxia, low birth weight and intrauterine fetal death)
  • Central infarcts, large ( > 3 cm) infarcts and multiple infarcts indicate significant reductions in uteroplacental blood flow
  • Minor areas of infarction are seen in 25% of placentas
  • Associated with maternal hypertension, preeclampsia, Rh incompatibility, connective tissue disorders, retroplacental hematomas (abruptio placenta, associated with cocaine) or maternal thrombophilia
Gross description
  • Pale, indurated focus with granular cut surface in placenta parenchyma
  • Recent infarcts are red and may not be appreciated
  • Grossly, the differential diagnosis includes hematomas (usually lobular), subchorionic fibrous plaques, perivillous fibrin deposition (usually venous lesions), intervillous laminated thrombi and intraplacental choriocarcinoma (looks grossly like an infarct)
Gross images

Images hosted on other servers:

Placental infarct

Microscopic (histologic) description
  • Collapsed villi with ghost-like appearance due to loss of nuclear basophilia / karyorrhexis
  • Intervillous space is obliterated due to increased fibrin deposition and villous agglutination
  • Marked congestion of villous vessels, lobular distribution
  • No villous stromal fibrosis, no cytotrophoblastic proliferation
Microscopic (histologic) images

Images hosted on other servers:

Pale necrotic chorionic villi