Placental villous immaturity

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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, villous edema, 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

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

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 but 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.
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
- LARGE PLACENTA (655 GRAMS -- TRIMMED, POST-FIXATION WEIGHT)
  WITH MILDLY LARGE VILLI AND FOCAL VILLOUS EDEMA, SEE COMMENT.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.

COMMENT:
Large villi and villous edema are findings of placental villous immaturity;
in this placenta, these changes are present but not well developed.

Placental villous immaturity is most often associated with maternal diabetes.

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.