placentitis
{{Infobox medical condition (new)
| name = Placentitis
| image = Gross pathology of severe intervillositis.jpg
| width =
| alt =
| caption = Gross pathology of severe intervillositis, with dark red and soggy tissue.
| pronounce =
| field = OB/GYN
}}
File:Histopathology of subchorionic intervillositis, annotated.jpg
Placentitis is an inflammation of the placenta. The main forms of placentitis are:
- Villitis, inflammation of chorionic villi.
- Intervillositis, inflammation of the intervillous space.{{cite journal|last1=Schubert|first1=Pawel T|last2=Mason|first2=Deidre|last3=Martines|first3=Roosacelis|last4=Deleon-Carnes|first4=Marlene|last5=Zaki|first5=Sherif R|last6=Roberts|first6=Drucilla J|title=Spectrum of Changes Seen With Placental Intravascular Organisms|journal=Pediatric and Developmental Pathology|volume=22|issue=3|year=2018|pages=229–235|issn=1093-5266|doi=10.1177/1093526618801616|pmid=30334666 |s2cid=52988584 }}
It may be caused by vertically transmitted infections.
Because of the close proximity, placentitis often occurs simultaneously as funisitis (inflammation of the umbilical cord) and chorioamnionitis (inflammation of the fetal membranes).
Chronic lymphocytic placental inflammation occurs in 5% to 15% of pregnancies, and are generally not associated with documented infection.{{cite book|last1=Redline|first1=Raymond W.|title=Fetal and Neonatal Pathology |chapter=Placental Inflammation|year=2007|pages=90–101|doi=10.1007/978-1-84628-743-5_4|isbn=978-1-84628-524-0 }}
Villitis of unknown etiology
{{Main|Villitis of unknown etiology}}
Villitis of unknown etiology (VUE), also known as chronic villitis, is a placental injury. VUE is an inflammatory condition involving the chorionic villi (placental villi). VUE is a recurrent condition and can be associated with intrauterine growth restriction (IUGR). IUGR involves the poor growth of the foetus, stillbirth, miscarriage, and premature delivery.{{Cite journal | last1 = Redline | first1 = RW. | title = Villitis of unknown etiology: noninfectious chronic villitis in the placenta. | journal = Hum Pathol | volume = 38 | issue = 10 | pages = 1439–46 |date=Oct 2007 | doi = 10.1016/j.humpath.2007.05.025 | pmid = 17889674 }}{{cite journal |vauthors=Tamblyn J, Lissauer D, Powell R, Cox P, Kilby M |title= The immunological basis of villitis of unknown etiology – Review |journal= Placenta |volume=34 |issue=10 |pages=846–55 |year=2013 |pmid=23891153 |doi=10.1016/j.placenta.2013.07.002 }} VUE recurs in about 1/3 of subsequent pregnancies.{{cite journal |vauthors=Feeley L, Mooney EE |title=Villitis of unknown aetiology: correlation of recurrence with clinical outcome |journal=J Obstet Gynaecol |volume=30 |issue=5 |pages=476–9 |year=2010 |pmid=20604650 |doi=10.3109/01443611003802339 |s2cid=11473529 }}
VUE is a common lesion characterised by inflammation in the placental chorionic villi. VUE is also characterised by the transfer of maternal lymphocytes across the placenta.
VUE is diagnosed in 7–10% placentas in pregnancies. Roughly 80% of the VUE cases are in term placentas (greater than 37 weeks of pregnancy). A case of VUE in a placenta less than 32 weeks old should be screened for infectious villitis.
Chronic histiocytic intervillositis
Chronic Histiocytic Intervillositis (CHI or CHIV) also known as Chronic Intervillositis of Unknown (A)etiology (CIUE) and Massive Chronic Intervillositis (MCI) is defined as a diffuse infiltration of mononuclear cells (histiocytes, lymphocytes, monocytes) of maternal origin into the intervillous space within the placenta. It often results in severe intrauterine growth restriction which can lead to miscarriage or stillbirth. Overall perinatal mortality rate is high: 41%{{cite journal|title=Chronic intervillositis of unknown etiology (CIUE): relation between placental lesions and perinatal outcome. |journal=European Journal of Obstetrics, Gynecology, and Reproductive Biology |pmid=19121887 | doi=10.1016/j.ejogrb.2008.06.012 |volume=143 |vauthors=Parant O, Capdet J, Kessler S, Aziza J, Berrebi A |year=2009 |issue=1 |pages=9–13}} to 77%.{{cite journal|title=Chronic histiocytic intervillositis: A placental lesion associated with recurrent reproductive loss. |journal=Human Pathology |pmid=11112214 | volume=31 |vauthors=Boyd TK, Redline RW |year=2000 |issue=11 |pages=1389–96 |doi=10.1016/s0046-8177(00)80009-x}} Recurrence rate is also high: 67% to 100%.
See also
References
{{reflist}}
External links
- [http://chisupport.org/ CHI Support]
- [https://www.facebook.com/groups/CHI.Support/ CHI Facebook Support Group]