HEMORRHAGIC ENDOVASCULITIS AND HEMORRHAGIC VILLITIS OF THE PLACENTA

  • 1 January 1980
    • journal article
    • research article
    • Vol. 104  (7) , 371-373
Abstract
A unique vascular lesion was identified in 32 human patients. Half of the associated infants are stillborn; 11 of 16 liveborn were in distress or small for gestational age. Placental vessels show thrombosis, endothelial and medial hyperplasia, and narrowing or obliteration of the lumen. A microangiopathic process is suggested by intraluminal fragmentation of erythrocytes [RBC] with diapedesis of intact and fragmented RBC through vessel walls. RBC fragments and hemosiderin are present within villous stroma. Nucleated RBC in placental vessels suggest fetal hypoxia. On gross examination, placentas are meconium stained. Umbilical cords are frequently edematous, redundant and around a fetal part; gradual narrowing of placental vessels may be related. Chronic villitis is present in 75% of cases; intranuclear inclusions were identified in 10%. An infectious agent, possibly viral, is suggested; toxic and chemical substances must be considered.

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