Difference between revisions of "Placental villous immaturity"

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

Latest revision as of 00:15, 27 June 2014

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.

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.

[Ref_Placenta_375-1] 1.0 ^1.1 Baergen, Rebecca N. (2011). Manual of Pathology of the Human Placenta (2nd ed.). Springer. pp. 375. ISBN 978-1441974938.

[pmid1856519-2] 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.

[pmid15138817-3] 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.

[pmid18382864-4] 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.

[1]

[2]

[3]

[4]

@@ Line 1: / Line 1: @@
-#redirect [[Placenta#Placental villous immaturity]]
+{{ Infobox diagnosis
+| Name       = {{PAGENAME}}
+| Image      = Placental_villous_immaturity_--_low_mag.jpg
+| Width      =
+| 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
+| Subtypes   =
+| LMDDx      = [[chorangiosis]], [[villous edema]], prematurity
+| Stains     =
+| IHC        =
+| EM         =
+| Molecular  =
+| IF         =
+| Gross      = +/-large placenta for gestational age
+| Grossing   =
+| Site       = [[placenta]]
+| Assdx      = [[diabetes]], [[placentomegaly]]
+| Syndromes  = [[Beckwith-Wiedemann syndrome]]
+| Clinicalhx = +/-diabetes
+| Signs      =
+| Symptoms   =
+| Prevalence = common
+| Bloodwork  = +/-elevated maternal blood sugar
+| Rads       =
+| Endoscopy  =
+| Prognosis  =
+| Other      =
+| ClinDDx    =
+}}
+'''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>
+==General==
+Associated with:
+*[[Diabetes mellitus]].<ref name=pmid1856519>{{Cite journal  | last1 = Arizawa | first1 = M. | last2 = Nakayama | first2 = M. | last3 = Kidoguchi | first3 = K. | title = [Correlation of placental villous immaturity and dysmaturity with clinical control of maternal diabetes]. | journal = Nihon Sanka Fujinka Gakkai Zasshi | volume = 43 | issue = 6 | pages = 595-602 | month = Jun | year = 1991 | doi =  | PMID = 1856519 }}</ref>
+*[[Beckwith-Wiedemann syndrome]].
+*Intrauterine fetal demise near term.<ref name=pmid15138817>{{Cite journal  | last1 = Stallmach | first1 = T. | last2 = Hebisch | first2 = G. | title = Placental pathology: its impact on explaining prenatal and perinatal death. | journal = Virchows Arch | volume = 445 | issue = 1 | pages = 9-16 | month = Jul | year = 2004 | doi = 10.1007/s00428-004-1032-2 | PMID = 15138817 }}</ref>
+==Microscopic==
+Features:<ref name=Ref_Placenta_375>{{Ref Placenta|375}}</ref>
+*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.<ref name=pmid18382864>{{Cite journal  | last1 = Daskalakis | first1 = G. | last2 = Marinopoulos | first2 = S. | last3 = Krielesi | first3 = V. | last4 = Papapanagiotou | first4 = A. | last5 = Papantoniou | first5 = N. | last6 = Mesogitis | first6 = S. | last7 = Antsaklis | first7 = A. | title = Placental pathology in women with gestational diabetes. | journal = Acta Obstet Gynecol Scand | volume = 87 | issue = 4 | pages = 403-7 | month =  | year = 2008 | doi = 10.1080/00016340801908783 | PMID = 18382864 }}</ref>
+DDx:
+*[[Chorangiosis]].
+*[[Villous edema]], isolated.
+===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>
+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)
+</gallery>
+==Sign out==
+===Large placenta and gestational age not provided===
+<pre>
+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.
+</pre>
+===Gestational age not provided===
+<pre>
+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.
+</pre>
+===Gestational age provided but not obvious===
+<pre>
+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.
+</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>
+==See also==
+*[[Diabetes]].
+*[[Placenta]].
+*[[Placentomegaly]].
+*[[Distal villous hypoplasia]].
+==References==
+{{Reflist|2}}
+[[Category:Placenta]]
 [[Category:Diagnosis]]