Delayed villous maturation with and without fetal demise: A case report of three successive pregnancies

TL;DR

This case report describes three pregnancies with delayed villous maturation and highlights the importance of placental histology in understanding pregnancy complications.

Contribution

The study emphasizes the clinical relevance of structured placental histology in pregnancies with delayed villous maturation and fetal demise.

Findings

Three pregnancies with delayed villous maturation resulted in varied neonatal outcomes despite similar placental lesions.

Placentas showed delayed villous maturation with positive CD15 immunostaining and villitis of unknown etiology.

Induction of labor at 36 weeks in subsequent pregnancies resulted in liveborn infants with differing weight profiles.

Abstract

This case study examined three subsequent pregnancies with delayed villous maturation (DVM) resulting in infants either large for gestational age (LGA) or appropriate for gestational age. A perinatal pathologist histopathologically reviewed the placentas using the Amsterdam Consensus Criteria. The first pregnancy ended in a term fetal demise of an LGA infant due to severe asphyxia associated with idiopathic DVM. Due to the history of stillbirth and DVM, labor was induced at 36 weeks of gestation in the second and third pregnancies. The second and third pregnancies resulted in liveborn infants with varying weight profiles despite similar placental lesions. All three placentas showed DVM with positive CD15 immunostaining. Additionally, the second and third placentas exhibited villitis of unknown etiology. This case report underscores the importance of structured histologic placental examination following complicated pregnancies by a perinatal pathologist.

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