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Placental gross/microscopic abnormalities, non-neoplastic


Reviewers: Mandolin Ziadie, M.D. (see Reviewers page)
Revised: 16 November 2011, last major update October 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.


● 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

Placental infarct

Micro 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

Micro images

Pale necrotic chorionic villi

End of Placenta > Placental gross/microscopic abnormalities, non-neoplastic > Infarct

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