Placenta - Abnormalities
|Embryology - 26 Jul 2017 Expand to Translate|
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- 1 Introduction
- 2 Some Recent Findings
- 3 Placenta Shape
- 4 Placenta Weight
- 5 Placenta Accreta
- 6 Placenta Increta
- 7 Placenta Percreta
- 8 Placenta Previa
- 9 Vasa Previa
- 10 Abruptio Placenta
- 11 Placenta Variants
- 12 Chronic Intervillositis
- 13 Placental Mesenchymal Dysplasia
- 14 Pre-eclampsia
- 15 Diabetic Placenta
- 16 Placental Chorioangioma
- 17 Hydatidiform Mole
- 18 Cord Abnormalities
- 19 Fetal Erythroblastosis
- 20 Placental Infections
- 21 Placental Membranes
- 22 Placental Pathology
- 23 International Classification of Diseases
- 24 References
- 25 External Links
- 26 Glossary Links
The placenta is a mateno-fetal organ which begins developing at implantation of the blastocyst and is delivered with the fetus at birth. As the fetus relies on the placenta for not only nutrition, but many other developmentally essential functions, the correct development of the placenta is important to correct embryonic and fetal development.
Abnormalities can range from anatomical associated with degree or site of inplantation, structure (as with twinning), to placental function, placento-maternal effects (pre-eclampsia, fetal erythroblastosis) and finally mechanical abnormalities associated with the placental (umbilical) cord.
Morbidly adherent placenta (MAP) is the general clinical term used to describe the different forms of abnormal placental implantation (Accreta, Increta and Percreta). Clinical ultrasound indicators are the presence of an interruption of the bladder line, absence of a retroplacental clear zone, and the presence of placental lacunae.
A 2009 longitudinal Norwegian study suggests an association between large placenta relative to fetal size "disproportionately large placenta relative to birth weight was associated with increased risk of (adult) cardiovascular disease death." See also the DOHAD hypothesis.
This current page lists some abnormalities associated with the placenta and also provides links to other resources. (See also Week 2 Abnormalities - Hydatidiform mole)
Some Recent Findings
|More recent papers|
This table shows an automated computer PubMed search using the listed sub-heading term.
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
Alessandra Lio, Paolo Rosati, Roberta Pastorino, Francesco Cota, Milena Tana, Chiara Tirone, Claudia Aurilia, Cinzia Ricci, Alessandro Gambacorta, Angela Paladini, Ilenia Mappa, Silvia Buongiorno, Gian Franco Zannoni, Costantino Romagnoli, Giovanni Vento Fetal Doppler velocimetry and bronchopulmonary dysplasia risk among growth-restricted preterm infants: an observational study. BMJ Open: 2017, 7(7);e015232 PubMed 28729313
Andrea A Zin, Irena Tsui, Julia Rossetto, Zilton Vasconcelos, Kristina Adachi, Stephanie Valderramos, Umme-Aiman Halai, Marcos Vinicius da Silva Pone, Sheila Moura Pone, Joel Carlos Barros Silveira Filho, Mitsue S Aibe, Ana Carolina C da Costa, Olivia A Zin, Rubens Belfort, Patricia Brasil, Karin Nielsen-Saines, Maria Elisabeth Lopes Moreira Screening Criteria for Ophthalmic Manifestations of Congenital Zika Virus Infection. JAMA Pediatr: 2017; PubMed 28715527
Ekaterina Chelysheva, Anna Turkina, Evgenia Polushkina, Roman Shmakov, Alexey Zeifman, Sergey Aleshin, Igor Shokhin, Dorel Guranda, Oksana Oksenjuk, Sergey Mordanov, Khamida Kazakbaeva, Ghermes Chilov Placental transfer of tyrosine kinase inhibitors used for chronic myeloid leukemia treatment. Leuk. Lymphoma: 2017;1-6 PubMed 28703026
Luca Marozio, Anna Garofalo, Paola Berchialla, Anna Maria Tavella, Loredana Salton, Franco Cavallo, Chiara Benedetto Low expression of soluble human leukocyte antigen G in early gestation and subsequent placenta-mediated complications of pregnancy. J. Obstet. Gynaecol. Res.: 2017; PubMed 28691395
Nannan He, Shujing J Lim, Joana C Moreira de Mello, Injerreau Navarro, Monika Bialecka, Daniela C F Salvatori, Lucette A J van der Westerlaken, Lygia V Pereira, Susana M Chuva de Sousa Lopes At Term, XmO and XpO Mouse Placentas Show Differences in Glucose Metabolism in the Trophectoderm-Derived Outer Zone. Front Cell Dev Biol: 2017, 5;63 PubMed 28680878
D P Kain, R D Ajavon, H Zamané, S Kiemtore, Y A Sawadogo, I Ouédraogo Obstetric hemorrhages at the CHU-Yalgado Ouédraogo of Ouagadougou : etiological, therapeutic, and prognostic aspects. [Les hémorragies obstétricales au service d’obstétrique du CHU Yalgado Ouédraogo de Ouagadougou : aspects étiologiques, thérapeutiques et pronostiques.] Med Sante Trop: 2017; PubMed 28721929
Michael W Parra, Carlos Alberto Ordonez, Juan P Herrera-Escobar, Adolfo Gonzalez-Garcia, Jon Guben Resuscitative Endovascular Balloon Occlusion of the Aorta for Placenta Percreta/Previa. J Trauma Acute Care Surg: 2017; PubMed 28715362
Jude S Morton, Alison S Care, Raven Kirschenman, Christy-Lynn Cooke, Sandra T Davidge Advanced Maternal Age Worsens Postpartum Vascular Function. Front Physiol: 2017, 8;465 PubMed 28713290
Bushra Khan, Farhat Deeba, Rubina Bashir, Wajiha Khan Out Come Of Trial Of Scar In Patients With Previous Caesarean Section. J Ayub Med Coll Abbottabad: 2017, 28(3);587-590 PubMed 28712242
Hiroki Ishibashi, Morikazu Miyamoto, Hiroshi Shinnmoto, Wakana Murakami, Hiroaki Soyama, Masaya Nakatsuka, Takahiro Natsuyama, Masashi Yoshida, Masashi Takano, Kenichi Furuya Cervical varicosities may predict placenta accreta in posterior placenta previa: a magnetic resonance imaging study. Arch. Gynecol. Obstet.: 2017; PubMed 28710549
Placentas are generally round or oval in shape and can also be "irregular" (multilobate, "star") shapes. These irregular shaped placentas have been associated with lower birth weight for placental weight suggesting an altered function. 
Embryo Virtual Slides
|Circumvallate placenta is an abnormally shaped placenta where the chorionic membranes are not inserted at the edge of the placenta, but are located inward from the margins toward the placental cord. The membranes are described as "doubled back" over the fetal surface of the placenta.|
A recent Canadian study of 87,600 singleton births has identified a number of risk factors for both high and low placental weight. Some factors are associated either before, after or both accounting for birthweight.
Low placental weight
- chronic hypertension (before and after accounting for birthweight).
- pre-eclampsia (before, but not after adjustment for birthweight).
High placental weight
- anaemia (before and after adjustment for birthweight).
- gestational diabetes (before and after adjustment for birthweight).
- smoking (after adjustment for birthweight).
- Placental and cord determinants include chorioamnionitis, chorangioma/chorangiosis, circumvallate placenta and marginal cord insertion.
Abnormal adherence, with absence of decidua basalis. The incidence of placenta accreta also significantly increases in women with previous cesarean section compared to those without a prior surgical delivery.
- Deficiency of retroplacental sonolucent zone
- Vascular lacunae
- Myometrial thinning
- Interruption of bladder line
| Placenta Increta occurs when the placenta attaches deep into the uterine wall and penetrates into the uterine muscle, but does not penetrate the uterine serosa.
Placenta Increta and Previa
|Placenta Percreta MRI|| Surgical photograph|
Showing the placenta extending through uterine wall (+) and covered by
thin serosal layer (arrow), no features of bladder invasion.
| Placental villi penetrate myometrium and through to uterine serosa.
See clinical article on the laparoscopic management of placenta percreta. 
Placenta Percreta Histopathology
Historically, Paul Portal (1630-1703), a French physician, was the first to describe in 1685 a case of placenta previa in his "The Compleat Practice of Men and Women Midwives".
In this placental abnormality, the placenta overlies internal cervical os of uterus, essentially covering the birth canal. This condition occurs in approximately 1 in 200 to 250 pregnancies and risk factors include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, and maternal age. A retrospective study of from 59,149 women of 724 pregnancies (1.2%) diagnosed with a complete or partial previa, identified no associated with fetal growth restriction.
In the third trimester and at term, abnormal bleeding can require caesarian delivery and can also lead to Abruptio Placenta.
Ultrasound screening programs during 1st and early 2nd trimester pregnancies now include placental localization. Diagnosis can also be made by transvaginal ultrasound.
Placenta previa MRI
A 2007 Canadian study identified that following first live birth delivery by caesarean section there is a 47% increased risk of placenta praevia and 40% increased risk of placental abruption in the second pregnancy with a singleton.
Ultrasound Placenta Previa
|Anterior placenta position (upper arrow) in relation to cervix os (lower arrow).||Posterior placenta position (arrow) in relation to cervix os (triangle).|
Placental tissue is seen on the anterior and posterior uterine wall and completely covers the cervix.
- Links: Ultrasound
| Vasa previa (vasa praevia) placental abnormality where the fetal vessels lie within the membranes close too or crossing the inner cervical os (opening) and generally diagnosed (98%) by ultrasound. This occurs normally in 1:2500-5000 pregnancies and leads to complications similar too those for placenta previa. Approximately 28% of prenatally diagnosis cases result in emergent preterm delivery.
Type II is defined as the condition where the fetal vessels are found crossing over the internal os connecting either a bilobed placenta or a succenturiate lobe with the main placental mass.
There are suggestions that colour doppler ultrasound can be used to visualise the blood vessels in high-risk cases and if required elective caesarean performed at 35–36 weeks in cases diagnosed as vasa praevia.
Two main associations:
Some recent evidence of successful in utero laser ablation of type II vasa previa at 22.5 weeks of gestation.
Vasa previa ultrasound movie
Management of vasa previa
The following text is from a recent paper identifying the Canadian guidelines for the management of vasa previa.
- If the placenta is found to be low lying at the routine second trimester ultrasound examination, further evaluation for placental cord insertion should be performed. (II-2B)
- Transvaginal ultrasound may be considered for all women at high risk for vasa previa, including those with low or velamentous insertion of the cord, bilobate or succenturiate placenta, or for those having vaginal bleeding, in order to evaluate the internal cervical os. (II-2B)
- If vasa previa is suspected, transvaginal ultrasound colour Doppler may be used to facilitate the diagnosis. Even with the use of transvaginal ultrasound colour Doppler, vasa previa may be missed. (II-2B)
- When vasa previa is diagnosed antenatally, an elective Caesarean section should be offered prior to the onset of labour. (II-1A)
- In cases of vasa previa, premature delivery is most likely; therefore, consideration should be given to administration of corticosteroids at 28 to 32 weeks to promote fetal lung maturation and to hospitalization at about 30 to 32 weeks. (II-2B)
- In a woman with an antenatal diagnosis of vasa previa, when there has been bleeding or premature rupture of membranes, the woman should be offered delivery in a birthing unit with continuous electronic fetal heart rate monitoring and, if time permits, a rapid biochemical test for fetal hemoglobin, to be done as soon as possible; if any of the above tests are abnormal, an urgent Caesarean section should be performed. (III-B
- Women admitted with diagnosed vasa previa should ideally be transferred for delivery in a tertiary facility where a pediatrician and blood for neonatal transfusion are immediately available in case aggressive resuscitation of the neonate is necessary. (II-3B)
- Women admitted to a tertiary care unit with a diagnosis of vasa previa should have this diagnosis clearly identified on the chart, and all health care providers should be made aware of the potential need for immediate delivery by Caesarean section if vaginal bleeding occurs. (III-B).
Represents interruption of the placenta by partial or complete separation, retroplacental blood clot formation and abnormal hemorrhage prior to delivery. There is significant perinatal mortality associated with abruptio placenta.
Placenta with two equal-sized lobes connected by a thin bridge. No identified risks of this structure.
Chorionic plate smaller than basal plate, edges rolled. Placental abruption and haemorrhage risks.
A rare placental abnormality where either all (diffuse placenta membranacea) or part (partial placenta membranacea) is covered by chorionic villi (placental cotyledons). Clinically the abnormality presents with vaginal bleeding, in the second or third trimester or during labor, due to an associated placenta previa. Ultrasound has been used to detect this condition.
Additional lobule separate from the main part of placenta. Risk of vessel rupture and placenta retention.
- Links: Ultrasound
(massive chronicintervillositis, chronic histiocytic intervillositis) Rare placental abnormality and pathology defined by inflammatory placental lesions, mainly in the intervillous space (IVS), with a maternal infiltrate of mononuclear cells (monocytes, lymphocytes, histiocytes) and intervillous fibrinoid deposition.
Chronic intervillositis of the placenta. Jacques SM, Qureshi F. Arch Pathol Lab Med. 1993 Oct;117(10):1032-5.
Placental Mesenchymal Dysplasia
Due to a similar "grape-like" placental appearance, this rare disorder placental mesenchymal stem villous hyperplasia has been mistaken both clinically and macroscopically for a partial hydatidiform molar pregnancy. The disorder also has a high incidence of both intrauterine growth restriction (IUGR) and fetal death. The placental abnormality may be detected, but difficult to diagnose, by ultrasound.
Current research suggests that placental cells may be originated from a mixed population of androgenetic (paternal-derived genome only) and biparental cells. This means that chorionic villus sampling can provide a differential diagnosis between this and a partial mole.
This condition is also known as gestational proteinuric hypertension and occurs in occurs in approximately 2 to 4% of all pregnancies. The pathogenesis of eclamptic convulsions remains unknown and women with a history of eclampsia are at increased risk of eclampsia (1-2%) and preeclampsia (22-35%) in subsequent pregnancies. "Magnesium sulfate is the drug of choice for reducing the rate of eclampsia developing intrapartum and immediately postpartum."(see Sibai BM. 2005).
Recent research using a large population study in Norway has shown a strong generational association such that daughters of women who had pre-eclampsia during pregnancy had more than twice the risk of pre-eclampsia themselves. The paper concludes "Maternal genes and fetal genes from either the mother or father may trigger pre-eclampsia. The maternal association is stronger than the fetal association. The familial association predicts more severe pre-eclampsia."
Maternal Type 1 diabetes can alter placental vascular development. Effects may be due to either maternal hyperglycaemia or fatal hyperinsulinaemia with high glucose and insulin shown in other systems to alter vascularity, increasing vascular endothelial growth factor (VEGF), nitric oxide (NO) and protein kinase C (PKC).
Features of the placental vessels include:
- Increased angiogenesis
- altered junctional maturity and molecular occupancy
- increased leakiness
The placental terminal villi also show vascularity changes including both hypovascularity and hypervascularity. A recent study of the normal and diabetic placenta, shows the diabetic placenta terminal villi were:
- hypovascular villi - had a smaller diameter and a wavy course
- hypervascular villi - had numerous capillaries, reduced stroma and were large in diameter.
Specific changes included:
- villous stroma - collagen envelope around capillaries looked thinner and the network of collagen fibers seemed less dense.
- stromal cells - loss of desmin filaments.
- villous capillaries - were more branched.
- Links: Maternal Diabetes
Chorioangiomas are the most common tumour of the placenta, occurring in approximately 1 % of all placentas and are generally benign vascular tumours (haemangiomas).
- Small chorioangiomas are generally not clinically significant and usually found incidentally.
- Large chorioangiomas have been associated with a range of fetal conditions (fetal anemia, thrombocytopenia, hydrops, hydramnios, intrauterine growth retardation) including prematurity and stillbirth.
|Placental Chorioangioma Ultrasound|
|Ultrasound scan placenta and chorioangioma||Ultrasound blood flow in chorioangioma|
Example of a placental chorioangioma forming a yellowish, well-circumscribed firm mass (5 cm × 5 cm) connected by two vessels to the placenta. Histopathologic examination revealed a placental disc 15 cm × 17 cm × 13 cm, with a three-vessel umbilical cord that was attached peripherally and measured 9 cm × 1.5 cm. The weight of the placenta was 530 g. The tumor was confirmed to be a chorioangioma.
Another type of abnormality is when only the conceptus trophoblast layers proliferates and not the embryoblast, no embryo develops, this is called a "hydatidiform mole" (HM), which is due to the continuing presence of the trophoblastic layer, this abnormal conceptus can also implant in the uterus. The trophoblast cells will secrete human chorionic gonadotropin (hCG), as in a normal pregnancy, and may appear maternally and by pregnancy test to be "normal". Prenatal diagnosis by ultrasound analysis demonstrates the absence of a embryo.
There are several forms of hydatidiform mole: partial mole, complete mole and persistent gestational trophoblastic tumor. Many of these tumours arise from a haploid sperm fertilizing an egg without a female pronucleus (the alternative form, an embryo without sperm contribution, is called parthenogenesis). The tumour has a "grape-like" placental appearance without enclosed embryo formation. Following a first molar pregnancy, there is approximately a 1% risk of a second molar pregnancy.
- The incidence of hydatidiform mole varies between ethnic groups, and typically occurs in 1 in every 1500 pregnancies.
- All hydatidiform mole cases are sporadic, except for extremely rare familial cases.
- A maternal gene has been identified for recurrent hydatidiform mole (chromosome 19q13.3-13.4 in a 15.2 cM interval flanked by D19S924 and D19S890).
Complete mole - chromosomal genetic material from the ovum (egg) is lost, by an unknown process. Fertilization then occurs with one or two sperm and an androgenic (from the male only) conceptus (fertilized egg) is formed. With this conceptus the embryo (fetus, baby) does not develop at all but the placenta does grow but it is abnormal and forms lots of cysts and has no blood vessels. These cysts look like a cluster of grapes and that is why it is called a hydatidiform mole (grape like). A hydatidiform mole miscarries by about 16 to 18 weeks gestational age. Since the diagnosis can be made by ultrasound before that time, it is better for you to have an evacuation of the uterus (D & C) so that there is no undue bleeding and no infection. Human chorionic gonadotropin (hCG) will assist in making the diagnosis.
Partial mole - three sets of chromosomes instead of the usual two and this is called triploidy. With such a pregnancy the chromosomal (genetic) material from the ovum (egg) is retained and the egg is fertilized by one or two sperm. Since with partial mole there are maternal chromosomes there is a fetus but because of the three sets of chromosomes this fetus is always grossly abnormal and will not survive. (Text modified from: International Society for the Study of Trophoblastic Diseases,see also JRM Gestational Trophoblastic Disease)
Like any tumour, unless removed there is a risk of progression:
- Stage I: Tumor confined to uterus (non-metastatic)
- Stage II: Tumor involving pelvic organs and/or vagina
- Stage III: Tumor involving lungs, with or without involving pelvic structures and/or vagina
- Stage IV: Tumor involving distant organs
Placental Mesenchymal Dysplasia
Due to a similar "grape-like" placental appearance, this rare disorder has been mistaken both clinically and macroscopically for a partial hydatidiform molar pregnancy. This disorder also has a high incidence of intrauterine growth restriction (IUGR) and fetal death.
Twin Pregnancy Mole
Hydatidiform mole and co-existent healthy fetus is a very rare condition with only 30 cases documented in detail in the literature.
- Links: International Society for the Study of Trophoblastic Diseases | Sydney Gynaecological Oncology Group Gestational Trophoblastic Disease | The Journal of Reproductive Medicine Gestational Trophoblastic Disease (1998) | Dana-Farber Cancer Institute Gynecologic Oncology Program
Velamentous Cord Insertion
(velamentous insertion) Clinical term for describing a placental abnormality where the placental cord inserts into the chorion laeve (placental membranes) away from the edge of the placenta. The placental vessels can also diverge as they traverse between the amnion and chorion before reaching the placenta.The placental vessels are therefore unprotected by Wharton's jelly where they traverse the membranes before they come together into the umbilical cord. This can cause hemorrhage if the vessels are damaged when the membranes are ruptured prior to birth. The condition is more common in monozygotic twins (15%) and triplets.
Velamentous cord insertion, with a low uterine body implantation site, has also been shown to affect fetal heart rate.
A bilobed placenta with velamentous cord insertion.
Cord Vessel Number
|Cord with one artery and one vein|
Persistent Right Umbilical Vein
A fairly rare anomaly, a study of 15,237 obstetric ultrasound examinations performed after 15 weeks' gestation identified only 33 cases of persistent right umbilical vein. Some studies have identified associated fetal anomalies with this condition, including cardiac abnormalities.
| There are few abnormalities associated with umbilical cord development, other that abnormally short or long cords, which in most cases do not cause difficulties.
In some cases though, long cords can wrap around limbs or the fetus neck, which can then restrict blood flow or lead to tissue or nerve damage, and therefore effect develoment.
Cord knotting can also occur (1%) in most cases these knots have no effect, in some cases of severe knotting this can prevents the passage of placental blood.
Umbilical cord torsion
|Rare umbilical cord torsion, even without knot formation can also affect placental blood flow, even leading to fetal demise.|
Refers to the separation of placental vessels before their attachment into the placenta.
This disease is also called Haemolytic Disease of the Newborn, an immune problem from fetus Rh+ /maternal Rh-, leakage from fetus causes anti-Rh antibodies, which is then dangerous for a 2nd child.
RHESUS BLOOD GROUP
Several infective agents may cross into the placenta from the maternal circulation, as well as enter the embry/fetal circulation. The variety of bacterial infections that can occur during pregnancy is as variable as the potential developmental effects, from virtually insignificant to a major developmental, abortive or fatal in outcome.
Pregnant women have an increased susceptibility to malaria infection. Malarial infection of the placenta by sequestration of the infected red blood cells leading to low birth weight and other effects. There are four types of malaria caused by the protozoan parasite Plasmodium falciparum (main), Plasmodium vivax, Plasmodium ovale, Plasmodium malariae). This condition is common in regions where malaria is endemic with women carrying their first pregnancy (primigravida).
A recent paper has identified using an in vitro model that human herpesvirus 8 (HHV-8) can infect the placenta
Clinical term for the cytomegalovirus infection of the placenta.
A earlier histological study identified fixed connective tissue cells predominantly infected cell type in placental tissue. In addition, endothelial cells, macrophages and in some cases trophoblast infection. While a more recent in vitro study suggests that all villi cell types are likely to be infected.
There are few documented abnormalities associated with feral membranes (chorion, amnion). Ultrasound measurement of abnormal yolk sac size/shape in early embryonic development has been suggested as an indicator of early gestational loss. The most common literature described abnormalities are those associated with abnormal vasularization of the chorion.
The best known environmental effect is infection of chorion and/or amnion referred to as chorioamnionitis.
Chronic Chorioamnionitis Histology
- Stage 1 ((a, b) inflammation showing infiltration of lymphocytes limited to the chorionic trophoblast layer (a). CD3 immunostaining demonstrates that the majority of these cells are T cells (b).
- Stage 2 (c, d) inflammation is characterized by infiltration of lymphocytes into the chorioamniotic connective tissue layer ((Stain - Haematoxylin Eosin), c), which are largely CD3+ T cells (d).
The following pathology information from.
This condition can occur following placental infection leading to maternal inflammation of the villous stroma, often with associated intervillositis. The inflammation can lead to disruption of blood flow and necrotic cell death.
Massive Chronic Intervillositis
(MCI) The maternal blood-filled space is filled with CD68-positive histiocytes and an increase in fibrin, occuring more commonly in the first trimester.
The prolonged meconium exposure leads to toxic death of myocytes of placental vessels (umbilical cord or chorionic plate).
A fetal malignancy that leads to an enlarged placenta, with tumor cells in the fetal circulation and rarely in the chorionic villi.
(protein C or S deficiency, factor V Leiden, sickle cell disease, antiphospholipid antibody) This condition can generate an increased fibrin/fibrinoid deposition in the maternal or intervillous space, this can trap and kill villi.
International Classification of Diseases
O12 Gestational oedema and proteinuria without hypertension
- O12.0 Gestational oedema
- O12.1 Gestational proteinuria
- O12.2 Gestational oedema with proteinuria
O13 Gestational hypertension without significant proteinuria
Incl.: Gestational hypertension NOS Mild pre-eclampsia
O14 Gestational hypertension with significant proteinuria
[pregnancy-induced] Excl.: superimposed pre-eclampsia (O11)
- O14.0 Moderate pre-eclampsia
- O14.1 Severe pre-eclampsia
- O14.2 HELLP syndrome Combination of hemolysis, elevated liver enzymes and low platelet count
- O14.9 Pre-eclampsia, unspecified
Incl.: convulsions following conditions in O10-O14 and O16 eclampsia with pregnancy-induced or pre-existing hypertension
- O15.0 Eclampsia in pregnancy
- O15.1 Eclampsia in labour
- O15.2 Eclampsia in the puerperium
- O15.9 Eclampsia, unspecified as to time period Eclampsia NOS
- Abruptio placentae (641.2)
- Placenta previa (641.0, 641.1)
- Postpartum hemorrhage (666.0–666.2)
- Kari R Risnes, Pål R Romundstad, Tom I L Nilsen, Anne Eskild, Lars J Vatten Placental weight relative to birth weight and long-term cardiovascular mortality: findings from a cohort of 31,307 men and women. Am. J. Epidemiol.: 2009, 170(5);622-31 PubMed 19638481
- Josefine Nasiell, Nikos Papadogiannakis, Erika Löf, Fanny Elofsson, Boubou Hallberg Hypoxic ischemic encephalopathy in newborns linked to placental and umbilical cord abnormalities. J. Matern. Fetal. Neonatal. Med.: 2015;1-6 PubMed 25714479
- M Jirkovská, T Kučera, J Kaláb, M Jadrníček, V Niedobová, J Janáček, L Kubínová, M Moravcová, Z Zižka, V Krejčí The branching pattern of villous capillaries and structural changes of placental terminal villi in type 1 diabetes mellitus. Placenta: 2012, 33(5);343-51 PubMed 22317894
- Junichi Hasegawa, Shinji Iwasaki, Ryu Matsuoka, Kiyotake Ichizuka, Akihiko Sekizawa, Takashi Okai Velamentous cord insertion caused by oblique implantation after in vitro fertilization and embryo transfer. J. Obstet. Gynaecol. Res.: 2011, 37(11);1698-701 PubMed 21651650
- M Yampolsky, C M Salafia, O Shlakhter, D Haas, B Eucker, J Thorp Modeling the variability of shapes of a human placenta. Placenta: 2008, 29(9);790-7 PubMed 18674815
- Helen McNamara, Jennifer A Hutcheon, Robert W Platt, Alice Benjamin, Michael S Kramer Risk factors for high and low placental weight. Paediatr Perinat Epidemiol: 2014, 28(2);97-105 PubMed 24354883
- Anne-Sophie Riteau, Mikael Tassin, Guillemette Chambon, Claudine Le Vaillant, Jocelyne de Laveaucoupet, Marie-Pierre Quéré, Madeleine Joubert, Sophie Prevot, Henri-Jean Philippe, Alexandra Benachi Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. PLoS ONE: 2014, 9(4);e94866 PubMed 24733409 | PLoS One.
- S M Zaideh, A T Abu-Heija, M F El-Jallad Placenta praevia and accreta: analysis of a two-year experience. Gynecol. Obstet. Invest.: 1998, 46(2);96-8 PubMed 9701688
- Yinka Oyelese, John C Smulian Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol: 2006, 107(4);927-41 PubMed 16582134
- Charleen Sze-Yan Cheung, Ben Chong-Pun Chan The sonographic appearance and obstetric management of placenta accreta. Int J Womens Health: 2012, 4;587-94 PubMed 23239929
- Kyong Wook Yi, Min-Jeong Oh, Tae-Seok Seo, Kyeong A So, Yu Chin Paek, Hai-Joong Kim Prophylactic hypogastric artery ballooning in a patient with complete placenta previa and increta. J. Korean Med. Sci.: 2010, 25(4);651-5 PubMed 20358016 | PMC2844598 | J Korean Med Sci.
- Binoj Varghese, Navdeep Singh, Regi A N George, Sareena Gilvaz Magnetic resonance imaging of placenta accreta. Indian J Radiol Imaging: 2013, 23(4);379-85 PubMed 24604945 | PMC3932583 | Indian J Radiol Imaging.
- Melanie Endres Ochalski, Amy Broach, Ted Lee Laparoscopic management of placenta percreta. J Minim Invasive Gynecol: 2009, 17(1);128-30 PubMed 20129349
- Minna Tikkanen, Vedran Stefanovic, Jorma Paavonen Placenta previa percreta left in situ - management by delayed hysterectomy: a case report. J Med Case Rep: 2011, 5;418 PubMed 21867547 | PMC3177929 | J Med Case Reports.
- P M Dunn Paul Portal (1630-1703), man-midwife of Paris. Arch. Dis. Child. Fetal Neonatal Ed.: 2006, 91(5);F385-7 PubMed 16923941
- Lorie M Harper, Anthony O Odibo, George A Macones, James P Crane, Alison G Cahill Effect of placenta previa on fetal growth. Am. J. Obstet. Gynecol.: 2010, 203(4);330.e1-5 PubMed 20599185
- Q Yang, S W Wen, L Oppenheimer, X K Chen, D Black, J Gao, M C Walker Association of caesarean delivery for first birth with placenta praevia and placental abruption in second pregnancy. BJOG: 2007, 114(5);609-13 PubMed 17355267
- Amar Bhide, Basky Thilaganathan Recent advances in the management of placenta previa. Curr. Opin. Obstet. Gynecol.: 2004, 16(6);447-51 PubMed 15534438
- Yinka Oyelese, John C Smulian Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol: 2006, 107(4);927-41 PubMed 16582134
- Society for Maternal-Fetal Medicine (SMFM) Publications Committee. Electronic address: email@example.com, Rachel G Sinkey, Anthony O Odibo, Jodi Dashe Society for Maternal-Fetal Medicine (SMFM) Consult Series #37: Diagnosis and Management of Vasa Previa. Am. J. Obstet. Gynecol.: 2015; PubMed 26292048
- Rubén A Quintero, Eftichia V Kontopoulos, Patricia W Bornick, Mary H Allen In utero laser treatment of type II vasa previa. J. Matern. Fetal. Neonatal. Med.: 2007, 20(12);847-51 PubMed 18050017
- P Sinha, S Kaushik, N Kuruba, S Beweley Vasa praevia: a missed diagnosis. J Obstet Gynaecol: 2008, 28(6);600-3 PubMed 19003654
- Robert Gagnon, Lucie Morin, Stephen Bly, Kimberly Butt, Yvonne M Cargill, Nanette Denis, Marja Anne Hietala-Coyle, Kenneth Ian Lim, Annie Ouellet, Maria-Hélène Raciot, Shia Salem, Diagnostic Imaging Committee, Lynda Hudon, Melanie Basso, Hayley Bos, Marie-France Delisle, Dan Farine, Kirsten Grabowska, Savas Menticoglou, William Mundle, Lynn Murphy-Kaulbeck, Tracy Pressey, Anne Roggensack, Maternal Fetal Medicine Committee Guidelines for the management of vasa previa. J Obstet Gynaecol Can: 2009, 31(8);748-60 PubMed 19772710
- Hamisu M Salihu, Brigitte Bekan, Muktar H Aliyu, Dwight J Rouse, Russell S Kirby, Greg R Alexander Perinatal mortality associated with abruptio placenta in singletons and multiples. Am. J. Obstet. Gynecol.: 2005, 193(1);198-203 PubMed 16021079
- Atif Ahmed, Enid Gilbert-Barness Placenta membranacea: a developmental anomaly with diverse clinical presentation. Pediatr. Dev. Pathol.: 2003, 6(2);201-2 PubMed 12532260
- B S Wilkins, G Batcup, P S Vinall Partial placenta membranacea. Br J Obstet Gynaecol: 1991, 98(7);675-9 PubMed 1883791
- Truc Pham, Julie Steele, Carla Stayboldt, Linda Chan, Kurt Benirschke Placental mesenchymal dysplasia is associated with high rates of intrauterine growth restriction and fetal demise: A report of 11 new cases and a review of the literature. Am. J. Clin. Pathol.: 2006, 126(1);67-78 PubMed 16753607
- Edi Vaisbuch, Roberto Romero, Juan Pedro Kusanovic, Offer Erez, Shali Mazaki-Tovi, Francesca Gotsch, Chong Jai Kim, Jung-Sun Kim, Lami Yeo, Sonia S Hassan Three-dimensional sonography of placental mesenchymal dysplasia and its differential diagnosis. J Ultrasound Med: 2009, 28(3);359-68 PubMed 19244073
- Wendy P Robinson, Julie L Lauzon, A Micheil Innes, Ken Lim, Snezana Arsovska, Deborah E McFadden Origin and outcome of pregnancies affected by androgenetic/biparental chimerism. Hum. Reprod.: 2007, 22(4);1114-22 PubMed 17185351
- M Arigita, M Illa, A Nadal, C Badenas, A Soler, N Alsina, A Borrell Chorionic villus sampling in the prenatal diagnosis of placental mesenchymal dysplasia. Ultrasound Obstet Gynecol: 2010, 36(5);644-5 PubMed 20503241
- Rolv Skjaerven, Lars J Vatten, Allen J Wilcox, Thorbjørn Rønning, Lorentz M Irgens, Rolv Terje Lie Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort. BMJ: 2005, 331(7521);877 PubMed 16169871
- Lopa Leach Placental vascular dysfunction in diabetic pregnancies: intimations of fetal cardiovascular disease? Microcirculation: 2011, 18(4);263-9 PubMed 21418381
- Lopa Leach, Alice Taylor, Flavia Sciota Vascular dysfunction in the diabetic placenta: causes and consequences. J. Anat.: 2009, 215(1);69-76 PubMed 19563553
- Inas Babic, Maha Tulbah, Wesam Kurdi Antenatal embolization of a large placental chorioangioma: a case report. J Med Case Rep: 2012, 6;183 PubMed 22759589 | PMC3419096 | J Med Case Rep
- Y B Moglabey, R Kircheisen, M Seoud, N El Mogharbel, I Van den Veyver, R Slim Genetic mapping of a maternal locus responsible for familial hydatidiform moles. Hum. Mol. Genet.: 1999, 8(4);667-71 PubMed 10072436
- Benjamin Piura, Alex Rabinovich, Relly Hershkovitz, Ester Maor, Moshe Mazor Twin pregnancy with a complete hydatidiform mole and surviving co-existent fetus. Arch. Gynecol. Obstet.: 2008, 278(4);377-82 PubMed 18273627
- Juliana Rocha, Joana Carvalho, Fernanda Costa, Isabel Meireles, Olímpia do Carmo Velamentous cord insertion in a singleton pregnancy: an obscure cause of emergency cesarean-a case report. Case Rep Obstet Gynecol: 2012, 2012;308206 PubMed 23243528 | PMC3517836 | Case Rep Obstet Gynecol.
- J Hasegawa, R Matsuoka, K Ichizuka, A Sekizawa, A Farina, T Okai Velamentous cord insertion into the lower third of the uterus is associated with intrapartum fetal heart rate abnormalities. Ultrasound Obstet Gynecol: 2006, 27(4);425-9 PubMed 16479618
- L M Hill, A Mills, C Peterson, D Boyles Persistent right umbilical vein: sonographic detection and subsequent neonatal outcome. Obstet Gynecol: 1994, 84(6);923-5 PubMed 7970470
- J Weichert, D Hartge, U Germer, R Axt-Fliedner, U Gembruch Persistent right umbilical vein: a prenatal condition worth mentioning? Ultrasound Obstet Gynecol: 2011, 37(5);543-8 PubMed 20922781
- Brianna Lide, William Lindsley, Margaret J Foster, Richard Hale, Sina Haeri Intrahepatic Persistent Right Umbilical Vein and Associated Outcomes: A Systematic Review of the Literature. J Ultrasound Med: 2015; PubMed 26635256
- M Hallak, P G Pryde, F Qureshi, M P Johnson, S M Jacques, M I Evans Constriction of the umbilical cord leading to fetal death. A report of three cases. J Reprod Med: 1994, 39(7);561-5 PubMed 7966052
- Mehmet Tunç Canda, Namık Demir, Latife Doganay Velamentous and Furcate Cord Insertion with Placenta Accreta in an IVF Pregnancy with Unicornuate Uterus. Case Rep Obstet Gynecol: 2013, 2013;539379 PubMed 24455351
- Mariantonietta Di Stefano, Maria Luisa Calabrò, Iole Maria Di Gangi, Santina Cantatore, Massimo Barbierato, Elisa Bergamo, Anfumbom Jude Kfutwah, Margherita Neri, Luigi Chieco-Bianchi, Pantaleo Greco, Loreto Gesualdo, Ahidjo Ayouba, Elisabeth Menu, Josè Ramòn Fiore In vitro and in vivo human herpesvirus 8 infection of placenta. PLoS ONE: 2008, 3(12);e4073 PubMed 19115001
- C Sinzger, H Müntefering, T Löning, H Stöss, B Plachter, G Jahn Cell types infected in human cytomegalovirus placentitis identified by immunohistochemical double staining. Virchows Arch A Pathol Anat Histopathol: 1993, 423(4);249-56 PubMed 8236822
- Liu Tao, Chen Suhua, Chen Juanjuan, Yin Zongzhi, Xiao Juan, Zhang Dandan In vitro study on human cytomegalovirus affecting early pregnancy villous EVT's invasion function. Virol. J.: 2011, 8;114 PubMed 21392403
- M Gantert, J V Been, A W D Gavilanes, Y Garnier, L J I Zimmermann, B W Kramer Chorioamnionitis: a multiorgan disease of the fetus? J Perinatol: 2010, 30 Suppl;S21-30 PubMed 20877404
- Chong Jai Kim, Roberto Romero, Juan Pedro Kusanovic, Wonsuk Yoo, Zhong Dong, Vanessa Topping, Francesca Gotsch, Bo Hyun Yoon, Je Geun Chi, Jung-Sun Kim The frequency, clinical significance, and pathological features of chronic chorioamnionitis: a lesion associated with spontaneous preterm birth. Mod. Pathol.: 2010, 23(7);1000-11 PubMed 20348884 | Mod Pathol.
- Drucilla J Roberts Placental pathology, a survival guide. Arch. Pathol. Lab. Med.: 2008, 132(4);641-51 PubMed 18384216
Gali Garmi, Raed Salim Epidemiology, etiology, diagnosis, and management of placenta accreta. Obstet Gynecol Int: 2012, 2012;873929 PubMed 22645616
| Obstet Gynecol Int. Khaled M Elsayes, Andrew T Trout, Aaron M Friedkin, Peter S Liu, Ronald O Bude, Joel F Platt, Christine O Menias Imaging of the placenta: a multimodality pictorial review. Radiographics: 2009, 29(5);1371-91 PubMed 19755601
J S Abramowicz, E Sheiner In utero imaging of the placenta: importance for diseases of pregnancy. Placenta: 2007, 28 Suppl A;S14-22 PubMed 17383721
A Messerschmidt, A Baschat, N Linduska, G Kasprian, P C Brugger, A Bauer, M Weber, D Prayer Magnetic resonance imaging of the placenta identifies placental vascular abnormalities independently of Doppler ultrasound. Ultrasound Obstet Gynecol: 2011, 37(6);717-22 PubMed 21105016
B Hargitai, T Marton, P M Cox Best practice no 178. Examination of the human placenta. J. Clin. Pathol.: 2004, 57(8);785-92 PubMed 15280396
J F Yetter Examination of the placenta. Am Fam Physician: 1998, 57(5);1045-54 PubMed 9518951
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- American Fam Physician. (1998) Examination of the Placenta PMID 9518951
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Cite this page: Hill, M.A. 2017 Embryology Placenta - Abnormalities. Retrieved July 26, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Placenta_-_Abnormalities
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