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Decidual Vasculopathy

  • Beverly B. RogersEmail author
  • M. Halit Pinar
Chapter

Abstract

Decidual vasculopathy of the placental membranes consists histopathologically of atherosis and mural hypertrophy of parietal arterioles. The clinical association of decidual vasculopathy in the membranes is the same as when these features are seen in the basal decidua, indicating maternal malperfusion of the placenta. There is a difference in the histogenesis of mural hypertrophy of arterioles in the parietal decidua, which is likely related to maternal blood pressure, compared to the thick musculature of arterioles in the basal decidua, which results in part from lack of vascular adaptation by extravillous trophoblast.

Keywords

Membranes Atherosis Mural hypertrophy Vasculopathy Placenta 

References

  1. 1.
    Redline RW, Boyd T, Campbell V, et al. Maternal vascular underperfusion: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol. 2004;7:237–49.PubMedGoogle Scholar
  2. 2.
    Khong TY. Acute atherosis in pregnancies complicated by hypertension, small-for-gestational-age infants, and diabetes mellitus. Arch Pathol Lab Med. 1991;115:722–5.PubMedGoogle Scholar
  3. 3.
    Kim YM, Chaemsaithong P, Romero R, et al. The frequency of acute atherosis in normal pregnancy and preterm labor, preeclampsia, small for gestational age, fetal death and midtrimester spontaneous miscarriage. J Matern Fetal Neonatal Med. 2015;28:2001–9.CrossRefGoogle Scholar
  4. 4.
    Winters R, Waters BL. What is adequate sampling of extraplacental membranes?: a randomized, prospective analysis. Arch Pathol Lab Med. 2008;132:1920–3.PubMedGoogle Scholar
  5. 5.
    Spinillo A, Gardella B, Bariselli S, Alfei A, Silini EM, Bello BD. Cerebroplacental Doppler ratio and placenta histopathological features in pregnancies complicated by fetal growth restriction. J Perinat Med. 2014;42:321–8.CrossRefGoogle Scholar
  6. 6.
    Smith SD, Dunk CE, Aplin JD, Harris LK, Jones RL. Evidence for immune cell involvement in decidual spiral arteriole remodeling in early human pregnancy. Am J Pathol. 2009;175:1959–71.CrossRefGoogle Scholar
  7. 7.
    Craven CM, Morgan T, Ward K. Decidual spiral artery remodelling begins before cellular interaction with cytotrophoblasts. Placenta. 1998;19:241–52.CrossRefGoogle Scholar
  8. 8.
    Hecht JL, Zsengeller ZK, Spiel M, Karumanchi SA, Rosen S. Revisiting decidual vasculopathy. Placenta. 2016;42:37–43.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PathologyChildren’s Healthcare of Atlanta and Emory University School of MedicineAtlantaUSA
  2. 2.Department of PediatricsChildren’s Healthcare of Atlanta and Emory University School of MedicineAtlantaUSA
  3. 3.Department of PathologyWomen and Infants Hospital and Alpert Medical School of Brown UniversityProvidenceUSA

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