Nonneoplastic placental conditions and abnormalities


Fetal thrombotic vasculopathy

Last author update: 1 October 2011
Last staff update: 27 May 2022

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PubMed Search: "Fetal thrombotic vasculopathy" placenta

Mandolin S. Ziadie, M.D.
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Cite this page: Ziadie MS. Fetal thrombotic vasculopathy. website. Accessed June 7th, 2023.
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)
  • 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
Microscopic (histologic) images

Contributed by Hillary Rose Elwood, M.D.

Sections demonstrate intravascular fibrin thrombi of skin / subcutis, not placenta; the patient was found to have antiphospholipid antibody syndrome

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