• Roberto Romero, Yeon Mee Kim, Percy Pacora, Chong Jai Kim, Neta Benshalom-Tirosh, Sunil Jaiman, Gaurav Bhatti, Jung-Sun Kim, Faisal Qureshi, Suzanne M Jacques, Eun Jung Jung, Lami Yeo, Bogdan Panaitescu, Eli Maymon, Sonia S Hassan, Chaur-Dong Hsu, and Offer Erez.
• Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, USA, and Detroit, MI,USA.
• J Perinat Med. 2018 Aug 28; 46 (6): 613-630.

AbstractObjective To determine the frequency and type of histopathologic lesions in placentas delivered by women with a normal pregnancy outcome. Methods This retrospective cohort study included placental samples from 944 women with a singleton gestation who delivered at term without obstetrical complications. Placental lesions were classified into the following four categories as defined by the Society for Pediatric Pathology and by our unit: (1) acute placental inflammation, (2) chronic placental inflammation, (3) maternal vascular malperfusion and (4) fetal vascular malperfusion. Results (1) Seventy-eight percent of the placentas had lesions consistent with inflammatory or vascular lesions; (2) acute inflammatory lesions were the most prevalent, observed in 42.3% of the placentas, but only 1.0% of the lesions were severe; (3) acute inflammatory lesions were more common in the placentas of women with labor than in those without labor; (4) chronic inflammatory lesions of the placenta were present in 29.9%; and (5) maternal and fetal vascular lesions of malperfusion were detected in 35.7% and 19.7%, respectively. Two or more lesions with maternal or fetal vascular features consistent with malperfusion (high-burden lesions) were present in 7.4% and 0.7%, respectively. Conclusion Most placentas had lesions consistent with inflammatory or vascular lesions, but severe and/or high-burden lesions were infrequent. Mild placental lesions may be interpreted either as acute changes associated with parturition or as representative of a subclinical pathological process (intra-amniotic infection or sterile intra-amniotic inflammation) that did not affect the clinical course of pregnancy.

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