The placenta and extraplacental membranes are an apposition of fetal and maternal tissues for the purposes of physiological exchange. The placenta has a finite life span and is the body's largest biopsy, and yet its examination is often neglected, even in cases of fetal and neonatal deaths, sick and premature neonates, and maternal complications of pregnancy. Several monographs and reviews on the placenta have provided a better understanding of its examination and pathology (Benirschke and Kaufmann 2000; Vogler et al. 2000; Khong 2001; Hargitai et al. 2004; Kraus et al. 2004; Faye-Peterson et al. 2005).
The introduction of noninvasive techniques to investigate the fetal well-being early in pregnancy, including antenatal diagnosis, has made it important for the pathologist to become familiar with the development and structure of the placenta through all stages of pregnancy. Significant pathological processes can affect the placenta before involving the fetus. Many placental and implantation site lesions can now be visualized by ultrasound, in utero magnetic resonance imaging, or Doppler ultrasound assessment of fetal, umbilical, and maternal vessels. Correlation of these findings with placental histopathology is important for quality assurance purposes. In recent times, examination of the placenta has come to assume an important role in obstetric litigation, commonly when there is perinatal death, fetal distress, or alleged cerebral hypoxia (Kraus 2003).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Ackerman J, Gilbert-Barness E (1997) Malignancy met-astatic to the products of conception: a case report with literature review. Pediatr Pathol Lab Med 17:577–586.
Ahmed A, Gilbert-Barness E (2003) Placenta membra-nacea: a developmental anomaly with diverse clinical presentation. Pediatr Dev Pathol 6:201–202.
Airas U, Heinonen S (2002) Clinical significance of true umbilical knots: a population-based analysis. Am J Perinatol 19:127–132.
Althabe O, Labarrere C (1985) Chronic villitis of unknown aetiology and intrauterine growth-retarded infants of normal and low ponderal index. Placenta 6:369–373.
Altshuler G (1984) Chorangiosis. An important placen-tal sign of neonatal morbidity and mortality. Arch Pathol Lab Med 108:71–74.
Altshuler G, Arizawa M, Molnar-Nadasdy G (1992) Meconium-induced umbilical cord vascular necrosis and ulceration: a potential link between the placenta and poor pregnancy outcome. Obstet Gynecol 79:760–766.
Altshuler G, Hyde S (1989) Meconium-induced vaso-contraction: a potential cause of cerebral and other fetal hypoperfusion and of poor pregnancy outcome. J Child Neurol 4:137–142.
Ananth CV, Oyelese Y, Yeo L, Pradhan A, Vintzileos AM (2005) Placental abruption in the United States, 1979 through 2001: temporal trends and potential determinants. Am J Obstet Gynecol 192:191–198.
Ansari T, Gillan JE, Condell D, Green CJ, Sibbons PD (2004) Analyses of the potential oxygen transfer capability in placentae from infants succumbing to sudden infant death syndrome. Early Hum Dev 76:127–138.
Ariel I, Anteby E, Hamani Y, Redline RW (2004) Pla-cental pathology in fetal thrombophilia. Hum Pathol 35:729–733.
Baldwin VJ (1994) Pathology of Multiple Pregnancy. Springer-Verlag, New York.
Baergen RN, Malicki D, Behling C, Benirschke K (2001) Morbidity, mortality, and placental pathology in excessively long umbilical cords: retrospective study. Pediatr Dev Pathol 4:144–153.
Baill IC, Moore GW, Hedrick LA (1989) Abscess of allantoic duct remnant. Am J Obstet Gynecol 1989;161:334–336.
Barth WH Jr, Genest DR, Riley LE, Frigoletto FD Jr, Benacerraf BR, Greene MF (1996) Uterine arcuate artery Doppler and decidual microvascular pathology in pregnancies complicated by type I diabetes mellitus. Ultrasound Obstet Gynecol 8:98–103.
Becroft DM, Thompson JM, Mitchell EA (2004) Placen-tal infarcts, intervillous fibrin plaques, and inter-villous thrombi: incidences, cooccurrences, and epidemiological associations. Pediatr Dev Pathol 7:26–34.
Bendon RW, Ray MB (1986) The pathologic findings of the fetal membranes in very prolonged amniotic fluid leakage. Arch Pathol Lab Med 110:47–50.
Bendon RW, Tyson RW, Baldwin VJ, Cashner KA, Mimouni F, Miodovnik M (1991). Umbilical cord ulceration and intestinal atresia: a new association? Am J Obstet Gynecol 164:582–586.
Benirschke K, Kaufmann P (2000) Pathology of the Human Placenta, 4th ed. Springer-Verlag, New York.
Berg TG, Rayburn WF (1995) Umbilical cord length and acid-base balance at delivery. J Reprod Med 40:9– 12.
Birkenfeld A, Mordel N, Okon E (1989) Direct demonstration of iron in a term placenta in a case of beta-thalassemia major. Am J Obstet Gynecol 160:562–563.
Blickstein I, Shoham-Schwartz Z, Lancet M (1987) Predisposing factors in the formation of true knots of the umbilical cord-analysis of morphometric and perinatal data. Int J Gynaecol Obstet 25:395–398.
Blickstein I, Varon Y, Varon E (2001) Implications of differences in coiling indices at different segments of the umbilical cord. Gynecol Obstet Invest 52:203– 206.
Boyd JD, Hamilton WJ (1970) The human placenta. Heffer and Sons, Cambridge, UK.
Boyd PA (1984) Quantitative structure of the normal human placenta from 10 weeks of gestation to term. Early Hum Dev 9:297–307.
Boyd PA, Scott A, Keeling JW (1986) Quantitative structural studies on placentas from pregnancies complicated by diabetes mellitus. Br J Obstet Gynaecol 93:31–35.
Brenner B, Kupferminc MJ (2003) Inherited thrombo-philia and poor pregnancy outcome. Best Pract Res Clin Obstet Gynaecol 17:427–439.
Burton GJ, Jauniaux E, Watson AL (1999) Maternal arterial connections to the placental intervillous space during the first trimester of human pregnancy: the Boyd collection revisited. Am J Obstet Gynecol 181:718–724.
Burton GJ, Palmer ME, Dalton KJ (1989) Morphometric differences between the placental vasculature of non-smokers, smokers and ex-smokers. Br J Obstet Gynaecol 96:907–915.
Caldarella A, Buccoliero AM, Taddei A, Savino L, Taddei GL (2003) Hemangioma of the umbilical cord: report of a case. Pathol Res Pract 199:51–55.
Carey JC, Rayburn WF (2003) Nuchal cord encirclements and birth weight. J Reprod Med 48:460– 462.
Chasnoff IJ, Fletcher MA (1977) True knot of the umbilical cord. Am J Obstet Gynecol 127:425–427.
Clapp JF 3rd, Stepanchak W, Hashimoto K, Ehrenberg H, Lopez B (2003) The natural history of antenatal nuchal cords. Am J Obstet Gynecol 189:488–493.
Clarson C, Tevaarwerk GJ, Harding PGR, Chance GW, Haust MD (1989) Placental weight in diabetic pregnancies. Placenta 10:275–281.
Costoya AL, Leontic EA, Rosenberg HG, Delgado MA (1980) Morphological study of placental terminal villi in intrahepatic cholestasis of pregnancy: histo-chemistry, light and electron microscopy. Placenta 1:361–368.
Denmead DT, Ariagno RL, Carson SH, Benirschke KB (1987) Placental pathology is not predictive for sudden infant death syndrome (SIDS). Am J Perina-tol 4:308–312.
Dommisse J, Tiltman AJ (1992) Placental bed biopsies in placental abruption. Br J Obstet Gynaecol 99:651–654.
Faye-Peterson O, Heller D, Joshi V (2005) Handbook of Placental Pathology. Taylor and Francis, New York.
Fox H (1967) The incidence and significance of nucleated erythrocytes in the foetal vessels of the mature human placenta. J Obstet Gynaecol Br Commonw 74:40–43.
Fox H (1997) Pathology of the Placenta, 2nd ed. WB Saunders, Philadelphia.
Fujikura T (2003) Fused umbilical arteries near placen-tal cord insertion. Am J Obstet Gynecol 188:765– 767.
Geirsson RT, Ogston SA, Patel NB, Christie AD (1985) Growth of total intrauterine, intra-amniotic and pla-cental volume in normal singleton pregnancy measured by ultrasound. Br J Obstet Gynaecol 92:46–53.
Genest DR (1992) Estimating the time of death in stillborn fetuses: II. Histologic evaluation of the placenta; a study of 71 stillborns. Obstet Gynecol 80:585–592.
Ghezzi F, Raio L, Di Naro E, Franchi M, Cromi A, Durig P (2003) Single and multiple umbilical cord cysts in early gestation: two different entities. Ultrasound Obstet Gynecol 21:215–219.
Gielchinsky Y, Mankuta D, Rojansky N, Laufer N, Gielchinsky I, Ezra Y (2004) Perinatal outcome of pregnancies complicated by placenta accreta. Obstet Gynecol 104:527–530.
Giles WB, Trudinger BJ, Baird PJ (1985) Fetal umbilical artery flow velocity waveforms and placental resistance: pathological correlation. Br J Obstet Gynaecol 92:31–38.
Goddijn-Wessel TAW, Wouters MGAJ, van de Molen EF, et al. (1996) Hyperhomocysteinemia: a risk factor for placental abruption or infarction. Eur J Obstet Gynecol Reprod Biol 66:23–29.
Godfrey KM, Redman CWG, Barker DJP, Osmond C (1991) The effect of maternal anaemia and iron defi-ciency on the ratio of fetal weight to placental weight. Br J Obstet Gynaecol 98:886–891.
Grati FR, Miozzo M, Cassani B, et al. (2005) Fetal and placental chromosomal mosaicism revealed by QF-PCR in severe IUGR pregnancies. Placenta 26:10–18.
Gruenwald P (1975) The supply line of the fetus; defini-tions relating to fetal growth. In: Gruenwald P, ed. The Placenta and Its Maternal Supply Line. MTP, Lancaster, pp. 1–7.
Hankins GDV, Snyder RR, Hauth JC, Gilstrap LC 3rd, Hammond T (1987) Nuchal cords and neonatal outcome. Obstet Gynecol 70:687–691.
Hargitai B, Marton T, Cox PM (2004) Best practice no 178. Examination of the human placenta. J Clin Pathol 57:785–792.
Harris BA Jr, Gore H, Flowers CE Jr (1985) Peripheral placental separation: a possible relationship to premature labor. Obstet Gynecol 66:774–778.
Heifetz SA (1988) Thrombosis of the umbilical cord: analysis of 52 cases and literature review. Pediatr Pathol 8:37–54.
Hershkovitz R, Silberstein T, Sheiner E, et al. (2001). Risk factors associated with true knots of the umbilical cord. Eur J Obstet Gynecol Reprod Biol 98:36–39.
Houlihan CM, Knuppel RA (1994) Meconium-stained amniotic fluid. Current controversies. J Reprod Med 39:888–898.
Jackson MR, Walsh AJ, Morrow RJ, Mullen JB, Lye SJ, Ritchie JW (1995) Reduced placental villous tree elaboration in small-for-gestational-age pregnancies: relationship with umbilical artery Doppler waveforms. Am J Obstet Gynecol 172:518–525.
Jauniaux E, Zucker M, Meuris S, Verhest A, Wilkin P, Hustin J (1988) Chorangiocarcinoma: an unusual tumour of the placenta. The missing link? Placenta 9:607–613.
Katzman PJ, Genest DR (2002) Maternal floor infarction and massive perivillous fibrin deposition: histo-logical definitions, association with intrauterine fetal growth restriction, and risk of recurrence. Pediatr Dev Pathol 5:159–164.
Kent AL, Dahlstrom JE (2006) Placental assessment: simple techniques to enhance best practice. Aust NZ J Obstet Gynaecol 46:32–37.
Khong TY (1991) Acute atherosis in pregnancies complicated by hypertension, small-for-gestational-age infants, and diabetes mellitus. Arch Pathol Lab Med 115:722–725.
Khong TY (2000) Chorangioma with trophoblastic proliferation. Virchows Arch 436:167–171.
Khong TY (2001) A topographical and clinical approach to examination of the placenta. Pathology 33:174– 186.
Khong TY (2002) What's in fibrin? Pediatr Dev Pathol 5:106–107.
Khong TY (2004) Placental vascular development and neonatal outcome. Semin Neonatol 9:255–263.
Khong TY, Chambers HM (1992) Alternative method of sampling placentas for the assessment of uteropla-cental vasculature. J Clin Pathol 45:925–927.
Khong TY, De Wolf F, Robertson WB, Brosens I (1986) Inadequate maternal vascular response to placenta-tion in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol 93:1049–1059.
Khong TY, Dilly SA (1989) Calcification of umbilical artery: two distinct lesions. J Clin Pathol 42:931– 934.
Khong TY, Ford WD, Haan EA (1994). Umbilical cord ulceration in association with intestinal atresia in a child with deletion 13q and Hirschsprung's disease. Arch Dis Child (Fetal Neonatal Ed) 71: F212–213.
Khong TY, George K (1992) Chromosomal abnormalities associated with a single umbilical artery. Prenat Diagn 12:965–968.
Khong TY, George K (1994) Maternal serum alpha-feto-protein levels in chorioangiomas. Am J Perinatol 11:245–248.
Khong TY, Hague WM (1999) The placenta in maternal hyperhomocysteinaemia. Br J Obstet Gynaecol 106:273–278.
Khong TY, Pearce JM, Robertson WB (1987) Acute ath-erosis in preeclampsia: maternal determinants and fetal outcome in the presence of the lesion. Am J Obstet Gynecol 157:360–363.
Khong TY, Robertson WB (1987) Placenta creta and placenta praevia creta. Placenta 8:399–409.
Khong TY, Sawyer IH, Heryet AR (1992) An immu-nohistologic study of endothelialization of utero-placental vessels in human pregnancy—evidence that endothelium is focally disrupted by tropho-blast in preeclampsia. Am J Obstet Gynecol 167:751–756.
Khong TY, Staples A, Bendon RW, et al (1995) Observer reliability in assessing placental maturity by histology. J Clin Pathol 48:420–423.
Khong TY, Werger AC (2001) Myometrial fibers in the placental basal plate can confirm but do not necessarily indicate clinical placenta accreta. Am J Clin Pathol 116:703–708.
Kos M, Czernobilsky B, Hlupic L, Kunjko K (2005) Pathological changes in placentas from pregnancies with preeclampsia and eclampsia with emphasis on persistence of endovascular trophoblastic plugs. Croat Med J 46:404–409.
Krakowiak P, Smith EN, de Bruyn G, Lydon-Rochelle MT (2004) Risk factors and outcomes associated with a short umbilical cord. Obstet Gynecol 103:119–127.
Kraus FT (2003) Perinatal pathology, the placenta, and litigation. Hum Pathol 34:517–521; discussion 522–527.
Kraus FT, Acheen VI (1999) Fetal thrombotic vascu-lopathy in the placenta: cerebral thrombi and infarcts, coagulopathies, and cerebral palsy. Hum Pathol 30:759–769.
Kraus FT, Redline RW, Gersell DJ, Nelson DM, Dicke JM (2004) Placental Pathology. American Registry of Pathology, Washington, DC.
Labarrere CA (1988) Acute atherosis. A histopathologi-cal hallmark of immune aggression? Placenta 9:95– 108.
Labarrere C, Sebastiani M, Siminovich M, Torassa E, Althabe O (1985) Absence of Wharton's jelly around the umbilical arteries: an unusual cause of perinatal mortality. Placenta 6:555–559.
Lage JM (1991) Placentomegaly with massive hydrops of placental stem villi, diploid DNA content, and fetal omphaloceles: possible association with Beckwith-Wiedemann syndrome. Hum Pathol 22:591–597.
Lake BD (1995) Histopathological investigation of prenatal tissue samples (excluding skin). In: Reed GB, Claireaux AE, Cockburn F, eds. Diseases of the Fetus and Newborn. Chapman & Hall, London, pp. 1089– 1097.
Langston C, Kaplan C, Macpherson T, et al. (1997) Practice guideline for examination of the placenta: developed by the Placental Pathology Practice Guideline Development Task Force of the College of American Pathologists. Arch Pathol Lab Med 121:449–476.
Lao TT, Tam KF (2000) Placental ratio and anemia in third-trimester pregnancy. J Reprod Med 45:923– 928.
Larsen LG, Clausen HV, Andersen B, Graem N (1995) A stereologic study of postmature placentas fixed by dual perfusion. Am J Obstet Gynecol 172:500–507.
Larsen LG, Clausen HV, Jonsson L (2002) Stereologic examination of placentas from mothers who smoke during pregnancy. Am J Obstet Gynecol 186:531– 537.
Lilja M (1991) Infants with single umbilical artery studied in a national registry. General epidemiologi-cal characteristics. Paediatr Perinat Epidemiol 5:27–36.
Lilja M (1992) Infants with single umbilical artery studied in a national registry. 2: Survival and malformations in infants with single umbilical artery. Pae-diatr Perinat Epidemiol 6:416–422.
Lin S, Shimizu I, Suehara N, Nakayama M, Aono T (1995) Uterine artery Doppler velocimetry in relation to trophoblast migration into the myometrium of the placental bed. Obstet Gynecol 85:760–765.
Linhart JM, Grafe MR, Saade GR, Velagaleti GV (2004) Sonographic, pathologic and karyotypic findings in a rare case of placenta fenestrata. Fetal Diagn Ther 19:479–482.
MacGillivray I, Nylander PPS, Corney G (1975) Human Multiple Reproduction. WB Saunders, Philadelphia.
Machin GA, Ackerman J, Gilbert-Barness E (2000) Abnormal umbilical cord coiling is associated with adverse perinatal outcomes. Pediatr Dev Pathol 3:462–471.
Maher JT, Conti JA (1996) A comparison of umbilical cord blood gas values between newborns with and without true knots. Obstet Gynecol 88:863–866.
Matorras R, Diez J, Pereira JG (1990) True knots in the umbilical cord: clinical findings and fetal consequences. J Obstet Gynaecol 10:383–386.
Mayhew TM, Burton GJ (1988) Methodological problems in placental morphometry: apologia for the use of stereology based on sound sampling practice. Placenta 9:565–581.
McDermott M, Gillan JE (1995) Trophoblast basement membrane haemosiderosis in the placental lesion of fetal artery thrombosis: a marker for disturbance of maternofetal transfer? Placenta 16:171–178.
Meekins JW, Pijnenborg R, Hanssens M, van Assche A, McFadyen IR (1994) Immunohistochemical detection of lipoprotein(a) in the wall of placental bed spiral arteries in normal and severe preeclamptic pregnancies. Placenta 15:511–524.
Miller PW, Coen RW, Benirschke K (1985) Dating the time interval from meconium passage to birth. Obstet Gynecol 66:459–462.
Mills JL, Harley EE, Moessinger AC (1983) Standards for measuring umbilical cord length. Placenta 4:423–426.
Mochizuki M, Maruo T, Masuko K, Ohtsu T (1984) Effects of smoking on fetoplacental-maternal system during pregnancy. Am J Obstet Gynecol 149:413–420.
Moessinger AC, Blanc WA, Marone PA, Polsen DC (1982) Umbilical cord length as an index of fetal activity: experimental study and clinical implications. Pediatr Res 16:109–112.
Mooney EE, al Shunnar A, O'Regan M, Gillan JE (1994) Chorionic villous haemorrhage is associated with ret-roplacental haemorrhage. Br J Obstet Gynaecol 101:965–969.
Naeye RL (1985) Umbilical cord length: clinical signifi-cance. J Pediatr 107:278–281.
Naeye RL (1990) The clinical significance of absent sub-chorionic fibrin in the placenta. Am J Clin Pathol 94:196–198.
Naeye RL (1992) Disorders of the placenta, fetus, and neonate: Diagnosis and clinical significance. Mosby, St. Louis.
Ogino S, Redline RW (2000) Villous capillary lesions of the placenta: distinctions between chorangioma, chorangiomatosis, and chorangiosis. Hum Pathol 31:945–954.
Ohyama M, Itani Y, Yamanaka M, et al. (2000) Umbilical cord ulcer: a serious in utero complication of intestinal atresia. Placenta 21:432–435.
Osak R, Webster KM, Bocking AD, Campbell MK, Richardson BS (1997) Nuchal cord evident at birth impacts on fetal size relative to that of the placenta. Early Hum Dev 49:193–202.
Paradinas FJ, Sebire NJ, Fisher RA, et al. (2001) Pseudo-partial moles: placental stem vessel hydrops and the association with Beckwith-Wiedemann syndrome and complete moles. Histopathology 39:447–454.
Pearlstone M, Baxi L (1993) Subchorionic hematoma: a review. Obstet Gynecol Surv 48:65–68.
Perry IJ, Beevers DG, Whincup PH, Bareford D (1995) Predictors of ratio of placental weight to fetal weight in multiethnic community. Br Med J 310:436–439.
Pijnenborg R, Bland JM, Robertson WB, Dixon G, Brosens I (1981) The pattern of interstitial tropho-blastic invasion of the myometrium in early human pregnancy. Placenta;2:303–316.
Pridmore BR, Khong TY, Wells WA (1994) Ultrasound placental cysts associated with massive placental stem villous hydrops, diploid DNA content, and exomphalos. Am J Perinatol 11:14–18.
Quek SP, Tan KL (1972) Vasa praevia. Aust N Z J Obstet Gynaecol 12:206–209.
Qureshi F, Jacques SM (1994) Marked segmental thinning of the umbilical cord vessels. Arch Pathol Lab Med 118:826–830.
Redline RW, Ariel I, Baergen RN, et al. (2004) Fetal vascular obstructive lesions: nosology and repro-ducibility of placental reaction patterns. Pediatr Dev Pathol 7:443–452.
Redline RW, Boyd T, Campbell V, et al. (2005) Maternal vascular underperfusion: nosology and reproducibil-ity of placental reaction patterns. Pediatr Dev Pathol 7:237–249.
Redline RW, Patterson P (1995) Pre-eclampsia is associated with an excess of proliferative immature intermediate trophoblast. Hum Pathol 26:594–600.
Robert JA, Sepulveda W (2003) Fetal exsanguination from ruptured vasa previa: still a catastrophic event in modern obstetrics. J Obstet Gynaecol 23:574.
Russell P (1980) Inflammatory lesions of the human placenta. III. The histopathology of villitis of unknown aetiology. Placenta 1:227–244.
Salihu HM, Bekan B, Aliyu MH, Rouse DJ, Kirby RS, Alexander GR (2005) Perinatal mortality associated with abruptio placenta in singletons and multiples. Am J Obstet Gynecol 193:198–203.
Sander CH, Kinnane L, Stevens NG, Echt R (1986) Haemorrhagic endovasculitis of the placenta: a review with clinical correlation. Placenta 7:551– 574.
Sander CM, Gilliland D, Richardson A, Foley KM, Fredericks J (2005) Stillbirths with placental hemor-rhagic endovasculitis: a morphologic assessment with clinical implications. Arch Pathol Lab Med 129:632–638.
Schaffer L, Burkhardt T, Zimmermann R, Kurmanavi-cius J (2005) Nuchal cords in term and postterm deliveries—do we need to know? Obstet Gynecol 106:23–28.
Sepulveda W, Corral E, Kottmann C, Illanes S, Vasquez P, Monckeberg MJ (2003) Umbilical artery aneurysm: prenatal identification in three fetuses with trisomy 18. Ultrasound Obstet Gynecol 21:292–296.
Shen-Schwarz S, Ruchelli E, Brown D (1989) Villous oedema of the placenta: a clinicopathological study. Placenta 10:297–307.
Sondergaard G (1994) Hemangioma of the umbilical cord. Acta Obstet Gynecol Scand 73:434–436.
Spellacy WN, Gravem H, Fisch RO (1966) The umbilical cord complications of true knots, nuchal coils, and cords around the body. Report from the collaborative study of cerebral palsy. Am J Obstet Gynecol 94:1136–1142.
Spencer MK, Khong TY (2003) Conformity to guidelines for pathologic examination of the placenta. Arch Pathol Lab Med 127:205–207.
Srinivasan R, Arora RS (2005) Do well infants born with an isolated single umbilical artery need investigation? Arch Dis Child 90:100–101.
Strong SJ, Corney G The Placenta in Twin Pregnancy. Pergamon, New York.
Strong TH Jr, Elliott JP, Radin TG (1993) Non-coiled umbilical blood vessels: a new marker for the fetus at risk. Obstet Gynecol 81:409–411.
Trudinger BJ, Giles WB, Cook CM, Bombardieri J, Collins L (1985) Fetal umbilical artery flow velocity waveforms and placental resistance: clinical signifi-cance. Br J Obstet Gynaecol 92:23–30.
van Diik CC, Franx A, de Laat MW, Bruinse HW, Visser GH, Nikkels PG (2002) The umbilical coiling index in normal pregnancy. J Matern Fetal Neonatal Med 11:280–283.
Van Horn JT, Craven C, Ward K, Branch DW, Silver RM (2004) Histologic features of placentas and abortion specimens from women with antiphospholipid and antiphospholipid-like syndromes. Placenta 25:642–648.
Vogler C, Petterchak J, Sotelo-Avila C, Thorpe C (2000) Placental pathology for the surgical pathologist. Adv Anat Pathol 7:214–229.
Walford N, Htun K, Akhilesh M (2005) Detection of atherosis in preeclamptic placentas: comparison of two gross sampling protocols. Pediatr Dev Pathol 8:61–65.
Wigglesworth JS (1964) Morphological variations in the insufficient placenta. J Obstet Gynaecol Br Commonw 71:871–884.
Wilkins-Haug L, Roberts DJ, Morton CC (1995) Confined placental mosaicism and intrauterine growth retardation: a case-control analysis of placentas at delivery. Am J Obstet Gynecol 172:44–50.
Wolstenholme J, Rooney DE, Davison EV (1994) Confined placental mosaicism, IUGR, and adverse pregnancy outcome: a controlled retrospective U.K. collaborative survey. Prenat Diagn 14:345–361.
Wu S, Kocherginsky M, Hibbard JU (2005) Abnormal placentation: twenty-year analysis. Am J Obstet Gynecol 192:1458–1461.
Zdravkovic T, Genbacev O, McMaster MT, Fisher SJ (2005) The adverse effects of maternal smoking on the human placenta: a review. Placenta 26(suppl A): S81–86.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer-Verlag London Limited
About this chapter
Cite this chapter
Khong, T.Y. (2007). The Placenta. In: Keeling, J.W., Khong, T.Y. (eds) Fetal and Neonatal Pathology. Springer, London. https://doi.org/10.1007/978-1-84628-743-5_3
Download citation
DOI: https://doi.org/10.1007/978-1-84628-743-5_3
Publisher Name: Springer, London
Print ISBN: 978-1-84628-524-0
Online ISBN: 978-1-84628-743-5
eBook Packages: MedicineMedicine (R0)