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Summary Placental bed spiral arteries underlying placental infarcts were studied in a hysterectomy specimen with the placenta in situ and in placental bed biopsies from cases of severe pre‐eclampsia. The spiral arteries supplying infarcted placentae differed from normal spiral arteries in two important features; first, in the failure of trophoblast infiltration and concomitant physiological changes of the myometrial segment of the spiral artery and, second, in the appearance in this segment of hypertensive, occlusive vascular lesions. Although placental infarction is apparently a direct result of the occlusive hypertensive lesions in the spiral arteries, it is also to be considered as the ultimate evidence of failure of adequate placentation.

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