Difference between revisions of "Placental villous immaturity"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Placental_villous_immaturity_-_low_mag.jpg | | Image = Placental_villous_immaturity_--_low_mag.jpg | ||
| Width = | | Width = | ||
| Caption = Placental villous immaturity. [[H&E stain]]. | | Caption = Placental villous immaturity. [[H&E stain]]. | ||
| Micro = Increased numbers of intermediate villi (in relation to the gestational age) - increased vascularity and more central vessels, edema, +/-macrophages, less mature terminal villi | | Micro = Increased numbers of intermediate villi (in relation to the gestational age) - increased vascularity and more central vessels, edema, +/-macrophages, less mature terminal villi | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[chorangiosis]], prematurity | | LMDDx = [[chorangiosis]], [[villous edema]], prematurity | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 12: | Line 12: | ||
| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = | | Gross = +/-large placenta for gestational age | ||
| Grossing = | | Grossing = | ||
| Site = | | Site = [[placenta]] | ||
| Assdx = [[diabetes]] | | Assdx = [[diabetes]], [[placentomegaly]] | ||
| Syndromes = [[Beckwith-Wiedemann syndrome]] | | Syndromes = [[Beckwith-Wiedemann syndrome]] | ||
| Clinicalhx = | | Clinicalhx = +/-diabetes | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = common | ||
| Bloodwork = | | Bloodwork = +/-elevated maternal blood sugar | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Line 28: | Line 28: | ||
| ClinDDx = | | ClinDDx = | ||
}} | }} | ||
'''Placental villous immaturity''', abbreviated ''PVI'', is a relatively common pathology of the [[placenta]]. | '''Placental villous immaturity''', abbreviated '''PVI''', is a relatively common pathology of the [[placenta]]. | ||
It is also known as '''distal villous immaturity''', '''villous immaturity''', and '''villous dysmaturity'''.<ref name=Ref_Placenta_375>{{Ref Placenta|375}}</ref> | It is also known as '''distal villous immaturity''', '''villous immaturity''', and '''villous dysmaturity'''.<ref name=Ref_Placenta_375>{{Ref Placenta|375}}</ref> | ||
| Line 49: | Line 49: | ||
DDx: | DDx: | ||
*[[Chorangiosis]]. | *[[Chorangiosis]]. | ||
*[[Villous edema]], isolated. | |||
===Images=== | ===Images=== | ||
<gallery> | |||
Image:Placental_villous_immaturity_--_low_mag.jpg |Placental villous immaturity - low mag. (WC) | |||
Image:Placental_villous_immaturity_--_intermed_mag.jpg |Placental villous immaturity - intermed. mag. (WC) | |||
Image:Placental_villous_immaturity_--_high_mag.jpg |Placental villous immaturity - high mag. (WC) | |||
</gallery> | |||
<gallery> | <gallery> | ||
Image:Placental_villous_immaturity_-_low_mag.jpg |Placental villous immaturity - low mag. (WC) | Image:Placental_villous_immaturity_-_low_mag.jpg |Placental villous immaturity - low mag. (WC) | ||
| Line 80: | Line 87: | ||
</pre> | </pre> | ||
===Gestational age provided | ===Gestational age provided but not obvious=== | ||
<pre> | <pre> | ||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: | PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: | ||
| Line 87: | Line 94: | ||
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | ||
- FETAL MEMBRANES WITHIN NORMAL LIMITS. | - FETAL MEMBRANES WITHIN NORMAL LIMITS. | ||
</pre> | |||
<pre> | |||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: | |||
- LARGE PLACENTA (655 GRAMS -- TRIMMED, POST-FIXATION WEIGHT) | |||
WITH MILDLY LARGE VILLI AND FOCAL VILLOUS EDEMA, SEE COMMENT. | |||
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | |||
- FETAL MEMBRANES WITHIN NORMAL LIMITS. | |||
COMMENT: | |||
Large villi and villous edema are findings of placental villous immaturity; | |||
in this placenta, these changes are present but not well developed. | |||
Placental villous immaturity is most often associated with maternal diabetes. | |||
</pre> | </pre> | ||
| Line 92: | Line 113: | ||
*[[Diabetes]]. | *[[Diabetes]]. | ||
*[[Placenta]]. | *[[Placenta]]. | ||
*[[Placentomegaly]]. | |||
*[[Distal villous hypoplasia]]. | |||
==References== | ==References== | ||
Latest revision as of 00:15, 27 June 2014
| Placental villous immaturity | |
|---|---|
| Diagnosis in short | |
 Placental villous immaturity. H&E stain. | |
|
| |
| LM | Increased numbers of intermediate villi (in relation to the gestational age) - increased vascularity and more central vessels, edema, +/-macrophages, less mature terminal villi |
| LM DDx | chorangiosis, villous edema, prematurity |
| Gross | +/-large placenta for gestational age |
| Site | placenta |
|
| |
| Associated Dx | diabetes, placentomegaly |
| Syndromes | Beckwith-Wiedemann syndrome |
|
| |
| Clinical history | +/-diabetes |
| Prevalence | common |
| Blood work | +/-elevated maternal blood sugar |
Placental villous immaturity, abbreviated PVI, is a relatively common pathology of the placenta.
It is also known as distal villous immaturity, villous immaturity, and villous dysmaturity.[1]
General
Associated with:
- Diabetes mellitus.[2]
- Beckwith-Wiedemann syndrome.
- Intrauterine fetal demise near term.[3]
Microscopic
Features:[1]
- Increased numbers of (immature) intermediate villi (in relation to the gestational age) with:
- Increased number of capillaries.
- Edema.
- Macrophages.
- Large diffusion distance (vessel-to-villous surface distance large).
- Less (mature) terminal villi.[4]
DDx:
- Chorangiosis.
- Villous edema, isolated.
Images
Placental villous immaturity - low mag. (WC)
Placental villous immaturity - intermed. mag. (WC)
Placental villous immaturity - high mag. (WC)
Placental villous immaturity - low mag. (WC)
Placental villous immaturity - intermed. mag. (WC)
Sign out
Large placenta and gestational age not provided
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: - LARGE PLACENTA (650 GRAMS -- TRIMMED, POST-FIXATION WEIGHT) WITH IMMATURE VILLI AND VILLOUS EDEMA, SEE COMMENT. - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. - FETAL MEMBRANES WITHIN NORMAL LIMITS. COMMENT: The findings are suggestive of placental villous immaturity.
Gestational age not provided
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: - PLACENTAL DISC WITH IMMATURE VILLI AND VILLOUS EDEMA, SEE COMMENT. - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. - FETAL MEMBRANES WITHIN NORMAL LIMITS. COMMENT: The findings are suggestive of placental villous immaturity.
Gestational age provided but not obvious
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: - PLACENTAL DISC WITH MILDLY LARGE VILLI FOR GESTATIONAL AGE AND FOCAL VILLOUS EDEMA. - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. - FETAL MEMBRANES WITHIN NORMAL LIMITS.
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: - LARGE PLACENTA (655 GRAMS -- TRIMMED, POST-FIXATION WEIGHT) WITH MILDLY LARGE VILLI AND FOCAL VILLOUS EDEMA, SEE COMMENT. - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. - FETAL MEMBRANES WITHIN NORMAL LIMITS. COMMENT: Large villi and villous edema are findings of placental villous immaturity; in this placenta, these changes are present but not well developed. Placental villous immaturity is most often associated with maternal diabetes.
See also
References
- ↑ 1.0 1.1 Baergen, Rebecca N. (2011). Manual of Pathology of the Human Placenta (2nd ed.). Springer. pp. 375. ISBN 978-1441974938.
- ↑ Arizawa, M.; Nakayama, M.; Kidoguchi, K. (Jun 1991). "[Correlation of placental villous immaturity and dysmaturity with clinical control of maternal diabetes].". Nihon Sanka Fujinka Gakkai Zasshi 43 (6): 595-602. PMID 1856519.
- ↑ Stallmach, T.; Hebisch, G. (Jul 2004). "Placental pathology: its impact on explaining prenatal and perinatal death.". Virchows Arch 445 (1): 9-16. doi:10.1007/s00428-004-1032-2. PMID 15138817.
- ↑ Daskalakis, G.; Marinopoulos, S.; Krielesi, V.; Papapanagiotou, A.; Papantoniou, N.; Mesogitis, S.; Antsaklis, A. (2008). "Placental pathology in women with gestational diabetes.". Acta Obstet Gynecol Scand 87 (4): 403-7. doi:10.1080/00016340801908783. PMID 18382864.