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DOI: 10.1055/s-0033-1357267
Fetal Thrombotic Vasculopathy and Perinatal Thrombosis: Should all Placentas be Examined?
Publication History
01 August 2013
26 August 2013
Publication Date:
09 October 2013 (online)
![](https://www.thieme-connect.de/media/ajp/201408/lookinside/thumbnails/10.1055-s-0033-1357267-1.jpg)
Abstract
Objective Numerous fetal placenta vascular lesions seem to be a predisposing condition for some types of perinatal disease. Placental disease and newborn thromboses might be both manifestations of the same underlying disorder. Objective of this study is to describe pathological lesions of the placenta in newborns with perinatal thrombosis.
Study Design We present retrospective data review and analysis regarding neonates admitted at our neonatal intensive care unit and diagnosed with an episode of thromboembolic events (TE) in the period from 2009 to 2013; among them we report three cases of perinatal thrombosis in newborns whose placentas demonstrated fetal thrombotic vasculopathy (FTV).
Results In all the three cases a prothrombotic maternal condition was found, and in one patient a maternal infection with chorioamnionitis; the histological examination of placenta, required soon after birth for maternal pathological conditions, was important in confirming and explaining the clinical diagnosis of neonatal thrombosis and for the management of future pregnancies.
Conclusion It is proposed that placenta of newborns with TE in first days of life should always be examined, for its association with FTV and thus the storage of placentas for a week after birth should be routinely implemented.
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References
- 1 Elbers J, Viero S, MacGregor D, DeVeber G, Moore AM. Placental pathology in neonatal stroke. Pediatrics 2011; 127 (3) e722-e729
- 2 Redline RW. Placental pathology and cerebral palsy. Clin Perinatol 2006; 33 (2) 503-516
- 3 Redline RW, O'Riordan MA. Placental lesions associated with cerebral palsy and neurologic impairment following term birth. Arch Pathol Lab Med 2000; 124 (12) 1785-1791
- 4 Redline RW. Severe fetal placental vascular lesions in term infants with neurologic impairment. Am J Obstet Gynecol 2005; 192 (2) 452-457
- 5 Redline RW, Pappin A. Fetal thrombotic vasculopathy: the clinical significance of extensive avascular villi. Hum Pathol 1995; 26 (1) 80-85
- 6 Wintermark P, Boyd T, Parast MM , et al. Fetal placental thrombosis and neonatal implications. Am J Perinatol 2010; 27 (3) 251-256
- 7 McDonald DG, Kelehan P, McMenamin JB , et al. Placental fetal thrombotic vasculopathy is associated with neonatal encephalopathy. Hum Pathol 2004; 35 (7) 875-880
- 8 Redline RW. Placental pathology: a systematic approach with clinical correlations. Placenta 2008; 29 (Suppl A): S86-S91
- 9 Redline RW. Clinical and pathological umbilical cord abnormalities in fetal thrombotic vasculopathy. Hum Pathol 2004; 35 (12) 1494-1498
- 10 Redline RW. Inflammatory responses in the placenta and umbilical cord. Semin Fetal Neonatal Med 2006; 11 (5) 296-301
- 11 Redline RW, Ariel I, Baergen RN , et al. Fetal vascular obstructive lesions: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol 2004; 7 (5) 443-452
- 12 Saleemuddin A, Tantbirojn P, Sirois K , et al. Obstetric and perinatal complications in placentas with fetal thrombotic vasculopathy. Pediatr Dev Pathol 2010; 13 (6) 459-464
- 13 Beeksma FA, Erwich JJ, Khong TY. Placental fetal vascular thrombosis lesions and maternal thrombophilia. Pathology 2012; 44 (1) 24-28
- 14 Taweevisit M, Thorner PS. Massive fetal thrombotic vasculopathy associated with excessively long umbilical cord and fetal demise: case report and literature review. Pediatr Dev Pathol 2010; 13 (2) 112-115
- 15 Gibbs RS. Chorioamnionitis and bacterial vaginosis. Am J Obstet Gynecol 1993; 169 (2 Pt 2) 460-462
- 16 Simhan HN, Caritis SN, Krohn MA, Martinez de Tejada B, Landers DV, Hillier SL. Decreased cervical proinflammatory cytokines permit subsequent upper genital tract infection during pregnancy. Am J Obstet Gynecol 2003; 189 (2) 560-567
- 17 Redline RW, Faye-Petersen O, Heller D, Qureshi F, Savell V, Vogler C ; Society for Pediatric Pathology, Perinatal Section, Amniotic Fluid Infection Nosology Committee. Amniotic infection syndrome: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol 2003; 6 (5) 435-448
- 18 Kraus FT, Acheen VI. Fetal thrombotic vasculopathy in the placenta: cerebral thrombi and infarcts, coagulopathies, and cerebral palsy. Hum Pathol 1999; 30 (7) 759-769
- 19 Leistra-Leistra MJ, Timmer A, van Spronsen FJ, Geven WB, van der Meer J, Erwich JJ. Fetal thrombotic vasculopathy in the placenta: a thrombophilic connection between pregnancy complications and neonatal thrombosis?. Placenta 2004; 25 (Suppl A): S102-S105
- 20 de Moerloose P, Boehlen F, Neerman-Arbez M. Fibrinogen and the risk of thrombosis. Semin Thromb Hemost 2010; 36 (1) 7-17
- 21 Hayes T. Dysfibrinogenemia and thrombosis. Arch Pathol Lab Med 2002; 126 (11) 1387-1390
- 22 Dahms BB, Boyd T, Redline RW. Severe perinatal liver disease associated with fetal thrombotic vasculopathy. Pediatr Dev Pathol 2002; 5 (1) 80-85
- 23 Redline RW, Shah D, Sakar H, Schluchter M, Salvator A. Placental lesions associated with abnormal growth in twins. Pediatr Dev Pathol 2001; 4 (5) 473-481
- 24 Kim TH, Lee HH, Chung SH, Park J, Kwak JJ. Fetal thrombotic vasculopathy accompanied by fetal growth restriction. J Matern Fetal Neonatal Med 2013; (e-pub ahead of print)
- 25 Khong TY. Placental vascular development and neonatal outcome. Semin Neonatol 2004; 9 (4) 255-263