Perinatal prognosis of pregnancies complicated by placental chronic villitis or intervillositis of unknown etiology and combined lesions: About a series of 178 cases

Nowak, Christel; Joubert, Madeleine; Jossic, F.; Masseau, A.; Hamidou, M.; Philippe, Henri-Jean; Vaillant, C. Le

doi:10.1016/j.placenta.2016.04.017

Cited by 43 publications

(49 citation statements)

References 16 publications

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“…Since then, many more studies have examined its epidemiology, clinical associations, and immunobiology. Some of these studies well document its recurrence risk (see for example and ).…”

Section: Villitis Of Unknown Etiologymentioning

confidence: 94%

“…The majority of the inflammatory cells are within the substance of the villous stroma, but there may be spillage of inflammation into the intervillous space , often with associated increased perivillous fibrin deposition . When intervillous inflammation is marked, the differential diagnosis of chronic histiocytic intervillositis or a combined lesion must be considered. Often, gross lesions are not described in cases of histologic VUE , but findings have been noted such as firmness and, in severe cases, parenchymal necrosis leading to mottling .…”

Section: Villitis Of Unknown Etiologymentioning

confidence: 99%

“…Further studies have revealed associations between VUE and maternal factors such as hypertensive disorders including preeclampsia , autoimmune disease such as systemic lupus erythematous and autoimmune thyroid disease , overweight/obesity and history of recurrent losses including intrauterine fetal demise (IUFD) and neonatal death . While the most common outcome of VUE is delivery of a healthy infant, the most common clinical condition associated with VUE is IUGR . VUE has been associated with many fetal/neonatal morbidities including abnormal cord flow by Doppler ultrasound , abnormal cord blood gases indicative of hypoxia , perinatal mortality , neonatal intensive care unit (NICU) admission , neonatal seizures , and neonatal encephalopathy and cerebral palsy (CP) .…”

Section: Villitis Of Unknown Etiologymentioning

confidence: 99%

“…In this review, we discuss these entities with a focus on the pathologic criteria for the diagnosis and the associated clinical relevance. Many excellent reviews for these three pathologic diagnoses have been published recently, and we encourage the readers to access them for further study [e.g., ].…”

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confidence: 99%

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Placental pathologic lesions with a significant recurrence risk – what not to miss!

Chen

Roberts

2017

APMIS

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Here, we review three important placental pathologies with significant clinical implications and recurrence risks. They are, in order of most to least frequently seen, villitis of unknown etiology, chronic histiocytic intervillositis, and massive perivillous fibrin deposition (also known as maternal floor infarction). These entities occur in both preterm and term gestations and are observed more frequently with maternal and obstetric disorders including prior pregnancy loss, hypertension/preeclampsia, and autoimmune disease. They are associated with, and probably the cause of, significant perinatal morbidity and mortality including intrauterine growth restriction, fetal and neonatal demise, and fetal/neonatal neurocompromise (seizures and cerebral palsy). All three entities have high recurrence risks, with recurrence rates ranging from 34 to 100%. The histologic features of villitis of unknown etiology, chronic histiocytic intervillositis, and massive perivillous fibrin deposition are described herein. We discuss the clinical associations and suggest the subsequent clinical and pathological evaluation. Hypotheses as to the biology of these lesions are reviewed.

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“…Since then, many more studies have examined its epidemiology, clinical associations, and immunobiology. Some of these studies well document its recurrence risk (see for example and ).…”

Section: Villitis Of Unknown Etiologymentioning

confidence: 94%

Section: Villitis Of Unknown Etiologymentioning

confidence: 99%

Section: Villitis Of Unknown Etiologymentioning

confidence: 99%

mentioning

confidence: 99%

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Placental pathologic lesions with a significant recurrence risk – what not to miss!

Chen

Roberts

2017

APMIS

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“…It may be of infectious origin (viral, bacterial), or, most commonly, of yet unknown etiology (VUE). If high grade, VUE may be recurrent and associated with perinatal pathology such as recurrent reproductive loss, fetal growth restriction (FGR), preterm birth, long-term neurological impairment, and cerebral palsy [3,4,5,6,7,8,9,10]. The mechanism of villous damage in VUE is the maternal anti-fetal immune reaction resembling allograft rejection, as it histologically features the inflammatory infiltrate containing predominantly maternal T-lymphocytes [11].…”

Section: Introductionmentioning

confidence: 99%

Placental infectious villitis versus villitis of unknown etiology

Stanek¹

2017

pjp

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To assess the incidence, diagnosis, pathogenesis, and clinical and placental associations of congenital cytomegalovirus infection, 34 cases thereof diagnosed by placental/fetal or neonatal workup (group 1), and 494 placentas with villitis of unknown etiology (group 2) were extracted from a 6083-case placental database. 28 clinical and 47 placental phenotypes were compared between the two groups by Yates c 2 or ANOVA using the Bonferroni correction. 26 group 1 cases did and 8 did not feature placental villitis, but all cases were positive as shown by immunohistochemistry and/or in situ hybridization. Only 5 differences were statistically significant (p Bonferroni < 0.0056): gestational age 29.8 ±6.5 vs. 35.5 ±4.9 weeks, perinatal mortality 67.6 vs. 16.2%, nonmacerated stillbirth 20.6 vs. 3.0%, macerated stillbirth 38.2 vs. 9.3%, and diffuse villous fibrosis 44.1 vs. 12.5%, between group 1 and group 2, respectively. The absence of significant differences in placental phenotypes between group 1 and group 2 other than the histological pattern of villitis indicates that not the cytomegalovirus villitis but the direct viral cytopathogenic effect on fetal organs makes the difference in the dire clinical outcome in the former. As about a third of cytomegalovirus infections show no villitis, the combination of the clinical picture and placental patterns creates the best chance to detect congenital cytomegalovirus infection.

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FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: Best practice advice for screening, diagnosis, and management of fetal growth restriction

Melamed

Baschat

Yinon

et al. 2021

Intl J Gynecology & Obste

286

218

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Perinatal prognosis of pregnancies complicated by placental chronic villitis or intervillositis of unknown etiology and combined lesions: About a series of 178 cases

Cited by 43 publications

References 16 publications

Placental pathologic lesions with a significant recurrence risk – what not to miss!

Placental pathologic lesions with a significant recurrence risk – what not to miss!

Placental infectious villitis versus villitis of unknown etiology

FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: Best practice advice for screening, diagnosis, and management of fetal growth restriction

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