Nonneoplastic placental conditions and abnormalities



Topic Completed: 1 October 2011

Minor changes: 20 October 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Infarct of the placenta [title]

Mandolin S. Ziadie, M.D.
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Cite this page: Ziadie MS. Infarct. website. Accessed December 6th, 2021.
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

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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

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Pale necrotic chorionic villi

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