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Difference between revisions of "Placenta"
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*Intravillous hemorrhage is non-specific - may arise in the following: early placental infarct, cord compression, abdominal trauma. | *Intravillous hemorrhage is non-specific - may arise in the following: early placental infarct, cord compression, abdominal trauma. | ||
= | =Inflammatory placenta= | ||
==General<ref name=Ref_PBoD1106>{{Ref PBoD|1106}}</ref> | ==Infection== | ||
General:<ref name=Ref_PBoD1106>{{Ref PBoD|1106}}</ref> | |||
*Infection usually ascending, i.e. from vagina up through cervix. | *Infection usually ascending, i.e. from vagina up through cervix. | ||
** | **Associated with intercourse. | ||
*Hematogenous rare - manifest as villitis. | *Hematogenous rare - manifest as villitis. | ||
**Think ''[[TORCH infections]]'' (toxoplasmosis, others ([[syphilis]], TB, listeriosis), rubella, cytomegalovirus, herpes simplex virus). | **Think ''[[TORCH infections]]'' (toxoplasmosis, others ([[syphilis]], TB, listeriosis), rubella, cytomegalovirus, herpes simplex virus). | ||
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===General=== | ===General=== | ||
Features:<ref name=pmid17889674>{{cite journal |author=Redline RW |title=Villitis of unknown etiology: noninfectious chronic villitis in the placenta |journal=Hum. Pathol. |volume=38 |issue=10 |pages=1439–46 |year=2007 |month=October |pmid=17889674 |doi=10.1016/j.humpath.2007.05.025 |url=}}</ref> | Features:<ref name=pmid17889674>{{cite journal |author=Redline RW |title=Villitis of unknown etiology: noninfectious chronic villitis in the placenta |journal=Hum. Pathol. |volume=38 |issue=10 |pages=1439–46 |year=2007 |month=October |pmid=17889674 |doi=10.1016/j.humpath.2007.05.025 |url=}}</ref> | ||
* | *Usually term placenta. | ||
*Prevalence: 5% to 15% of all placentas. | *Prevalence: 5% to 15% of all placentas. | ||
*Associated with: | *Associated with: | ||
**Intrauterine growth restriction. | **Intrauterine growth restriction. | ||
**Recurrent reproductive loss. | **Recurrent reproductive loss -- '''key point'''. | ||
Etiology: | |||
*Unknown - as the name of the entity suggests. | |||
**Suspected to be immune-mediated. | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=pmid17889674/> | Features:<ref name=pmid17889674/> | ||
* | *Lymphocytes in villous stroma - '''key feature'''. | ||
**Usually focal/patchy. | |||
**Lymphocytes: maternal derivation, T-lymphocytes -- mostly CD8-positive. | |||
*+/-Intervillositis (lymphocytes between villi). | *+/-Intervillositis (lymphocytes between villi). | ||
*+/-Histiocytes. | |||
*No plasma cells - this suggests an infectious etiology.<ref>CS. 7 February 2011.</ref> | |||
**Plasma cells may be in the decidua. | |||
Notes: | |||
*Neutrophils are usually absent. A significant number of 'em is suggestive of an infectious villitis. | |||
*Infective villitis is usu. B-cell predominant. | |||
Images: | Images: | ||