Placenta with infarction
Clinical story
31 years old female admitted to the hospital due to severe preeclampsia in week 30. She was given anti-hypertensive treatment, but three weeks later no fetal sound was audible. The child was small for size but showed no other pathology at autopsy. The placenta showed grossly dark red to brighter, pink or white areas, consistent with fresh end older infarctions, constituting approximately 50% of the tissue. Sections were taken from a pink area and from normal-looking placental tissue.
Comments
The section through the pinkish area shows a hemorrhagic infarction. Individual cells are difficult to distinguish, but can be recognized as "ghosts" with necrotic nuclei. A blood clot is blocking a former spiral artery, which appears as an opening in the maternal surface. The intervillous tissue is eosinophilic, with fibrin, erythrocytes and debris. The adjacent placental tissue shows increased amount of terminal villi as a reaction to ischemia ("premature maturation").
Learning goals
To understand the different vascular compartments of the placenta and its different circulation related diseases.