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Placenta (view source)

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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.
*Seen in [[intrauterine growth restriction]] (IUGR).
 
===Microscopic===
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>
*Mild or moderate:
*#Perivascular inflammatory cells.
*#+/-Vascular [[thrombosis]].
*#Smooth muscle hypertrophy.
*#Endothelial hyperplasia.
*#*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'''.
*Severe:<ref name=pmid18641412/>
*#Atherosis of maternal blood vessels.
*#*Foamy macrophages within vascular wall.
*#[[Fibrinoid necrosis]] of vessel wall (amorphous eosinophilic material vessel wall).
*Suggestive:<ref>{{Ref Placenta|339}}</ref>
**Decidual vasculitis - lymphocyte predominant without plasma cells.
 
Note:
*''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>
 
====Images====
<gallery>
Image:Hypertrophic_decidual_vasculopathy_intermed_mag.jpg | HDV - intermed. mag. (WC)
Image:Hypertrophic_decidual_vasculopathy_low_mag.jpg | HDV - low mag. (WC)
</gallery>
www:
*[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>
*[http://www.surgpath4u.com/caseviewer.php?case_no=490 Decidual vasculopathy (surgpath4u.com)].
*[http://www.brown.edu/Courses/Digital_Path/systemic_path/cardio/decidualvasculopathy.html Decidual vasculopathy (brown.edu)].
 
===Sign out===
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAREAN SECTION:
- DECIDUAL VASCULOPATHY.
- PLACENTA SMALL FOR GESTATIONAL AGE (222 GRAMS).
- PLACENTAL DISC WITH EARLY THIRD TRIMESTER VILLI WITH:
-- MULTIPLE PLACENTAL INFARCTS.
-- PERIVILLOUS FIBRIN DEPOSITION.
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.
 
COMMENT:
The 10th percentile placental mass (pre-fixation) for 32 weeks and 6
days is approximately 247 grams.
</pre>
 
====Suggestive of decidual vasculopathy====
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAREAN SECTION:
- CHANGES SUGGESTIVE OF DECIDUAL VASCULOPATHY (DECIDUAL VASCULITIS).
- PLACENTAL DISC WITH EARLY THIRD TRIMESTER VILLI AND A PLACENTAL INFARCT
  (2.5 CM IN MAXIMAL DIMENSION).
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.
</pre>


==HELLP syndrome==
==HELLP syndrome==
Michael
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