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| ==Hypertrophic decidual vasculopathy== | | ==Hypertrophic decidual vasculopathy== |
| :''Decidual vasculopathy'' redirects here. | | :[[AKA]] ''decidual vasculopathy''. |
| ===General===
| | {{Main|Hypertrophic decidual vasculopathy}} |
| *A change seen in hypertension.
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| *Seen in [[intrauterine growth restriction]] (IUGR).
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| ===Microscopic===
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| Features:<ref name=pmid18641412>{{Cite journal | last1 = Roberts | first1 = DJ. | last2 = Post | first2 = MD. | title = The placenta in pre-eclampsia and intrauterine growth restriction. | journal = J Clin Pathol | volume = 61 | issue = 12 | pages = 1254-60 | month = Dec | year = 2008 | doi = 10.1136/jcp.2008.055236 | PMID = 18641412 }}</ref>
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| *Mild or moderate:
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| *#Perivascular inflammatory cells.
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| *#+/-Vascular [[thrombosis]].
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| *#Smooth muscle hypertrophy.
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| *#Endothelial hyperplasia.
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| *#*Above two lead to narrowing of the decidual spiral arteries<ref>AFIP - Placental Pathology. P.122. ISBN: 1-881041-89-1. 2004.</ref> -- '''key feature'''.
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| *Severe:<ref name=pmid18641412/>
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| *#Atherosis of maternal blood vessels.
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| *#*Foamy macrophages within vascular wall.
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| *#[[Fibrinoid necrosis]] of vessel wall (amorphous eosinophilic material vessel wall).
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| *Suggestive:<ref>{{Ref Placenta|339}}</ref>
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| **Decidual vasculitis - lymphocyte predominant without plasma cells.
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| Note:
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| *''Smooth muscle hypertrophy'' can also be understood as ''lack of physiological conversion of spiral arteries of the uterus''.<ref name=pmid12848643>{{Cite journal | last1 = Naicker | first1 = T. | last2 = Khedun | first2 = SM. | last3 = Moodley | first3 = J. | last4 = Pijnenborg | first4 = R. | title = Quantitative analysis of trophoblast invasion in preeclampsia. | journal = Acta Obstet Gynecol Scand | volume = 82 | issue = 8 | pages = 722-9 | month = Aug | year = 2003 | doi = | PMID = 12848643 }}</ref>
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| ====Images====
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| <gallery>
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| Image:Hypertrophic_decidual_vasculopathy_intermed_mag.jpg | HDV - intermed. mag. (WC)
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| Image:Hypertrophic_decidual_vasculopathy_low_mag.jpg | HDV - low mag. (WC)
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| </gallery>
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| www:
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| *[http://path.upmc.edu/cases/case75/images/micro2.jpg Atherosis (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case75.html http://path.upmc.edu/cases/case75.html]. Accessed on: 2 January 2012.</ref>
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| *[http://www.surgpath4u.com/caseviewer.php?case_no=490 Decidual vasculopathy (surgpath4u.com)].
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| *[http://www.brown.edu/Courses/Digital_Path/systemic_path/cardio/decidualvasculopathy.html Decidual vasculopathy (brown.edu)].
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| ===Sign out===
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| <pre>
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| PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAREAN SECTION:
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| - DECIDUAL VASCULOPATHY.
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| - PLACENTA SMALL FOR GESTATIONAL AGE (222 GRAMS).
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| - PLACENTAL DISC WITH EARLY THIRD TRIMESTER VILLI WITH:
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| -- MULTIPLE PLACENTAL INFARCTS.
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| -- PERIVILLOUS FIBRIN DEPOSITION.
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| - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
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| - FETAL MEMBRANES WITHIN NORMAL LIMITS.
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| COMMENT:
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| The 10th percentile placental mass (pre-fixation) for 32 weeks and 6
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| days is approximately 247 grams.
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| </pre>
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| ====Suggestive of decidual vasculopathy====
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| <pre>
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| PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAREAN SECTION:
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| - CHANGES SUGGESTIVE OF DECIDUAL VASCULOPATHY (DECIDUAL VASCULITIS).
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| - PLACENTAL DISC WITH EARLY THIRD TRIMESTER VILLI AND A PLACENTAL INFARCT
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| (2.5 CM IN MAXIMAL DIMENSION).
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| - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
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| - FETAL MEMBRANES WITHIN NORMAL LIMITS.
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| </pre>
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| ==HELLP syndrome== | | ==HELLP syndrome== |