Placental villous immaturity

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Placental villous immaturity, abbreviated PVI, is a relatively common pathology of the placenta.

Placental villous immaturity
Diagnosis in short

Placental villous immaturity. H&E stain.

LM Increased numbers of intermediate villi (in relation to the gestational age) - increased vascularity and more central vessels, edema, +/-macrophages, less mature terminal villi
LM DDx chorangiosis, prematurity
Gross +/-large placenta for gestational age
Site placenta

Associated Dx diabetes, placentomegaly
Syndromes Beckwith-Wiedemann syndrome

Clinical history +/-diabetes
Prevalence common
Blood work +/-elevated maternal blood sugar

It is also known as distal villous immaturity, villous immaturity, and villous dysmaturity.[1]

General

Associated with:

Microscopic

Features:[1]

  • Increased numbers of (immature) intermediate villi (in relation to the gestational age) with:
    • Increased number of capillaries.
    • Edema.
    • Macrophages.
    • Large diffusion distance (vessel-to-villous surface distance large).
  • Less (mature) terminal villi.[4]

DDx:

Images

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Large placenta and gestational age not provided

PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
- LARGE PLACENTA (650 GRAMS -- TRIMMED, POST-FIXATION WEIGHT) 
  WITH IMMATURE VILLI AND VILLOUS EDEMA, SEE COMMENT.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.

COMMENT:
The findings are suggestive of placental villous immaturity.

Gestational age not provided

PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
- PLACENTAL DISC WITH IMMATURE VILLI AND VILLOUS EDEMA, SEE COMMENT.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.

COMMENT:
The findings are suggestive of placental villous immaturity.

Gestational age provided by not obvious

PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
- PLACENTAL DISC WITH MILDLY LARGE VILLI FOR GESTATIONAL AGE AND FOCAL 
  VILLOUS EDEMA.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.

See also

References

  1. 1.0 1.1 Baergen, Rebecca N. (2011). Manual of Pathology of the Human Placenta (2nd ed.). Springer. pp. 375. ISBN 978-1441974938.
  2. Arizawa, M.; Nakayama, M.; Kidoguchi, K. (Jun 1991). "[Correlation of placental villous immaturity and dysmaturity with clinical control of maternal diabetes].". Nihon Sanka Fujinka Gakkai Zasshi 43 (6): 595-602. PMID 1856519.
  3. Stallmach, T.; Hebisch, G. (Jul 2004). "Placental pathology: its impact on explaining prenatal and perinatal death.". Virchows Arch 445 (1): 9-16. doi:10.1007/s00428-004-1032-2. PMID 15138817.
  4. Daskalakis, G.; Marinopoulos, S.; Krielesi, V.; Papapanagiotou, A.; Papantoniou, N.; Mesogitis, S.; Antsaklis, A. (2008). "Placental pathology in women with gestational diabetes.". Acta Obstet Gynecol Scand 87 (4): 403-7. doi:10.1080/00016340801908783. PMID 18382864.