Placental Development and Complications of Previable Pregnancy
Diagnostic Gynecologic and Obstetric Pathology, Page: 1070-1102
2018
- 4Citations
- 24Captures
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Book Chapter Description
Evaluation of the products of conception in the previable period requires knowledge of fetal and placental development across gestation. The placenta is comprised of two types of trophoblast—cytotrophoblast and syncytiotrophoblast, which comprise the outer linings of chorionic villi, the villous compartment of the placenta, required for gas and nutrient exchange. The extravillous trophoblast compartment includes cells that invade the uterus and remodel maternal vessels to establish blood flow into the intervillous space of the placenta, chorionic trophoblast in the fetal membranes, and cells within the intraplacental trophoblast islands. Abnormalities of fetal and placental development can result in pregnancy complications. Abnormal fetal development, secondary to aneuploidy or environmental disruption (e.g., amnion band sequence), can lead to severe fetal malformations and pregnancy loss. Abnormalities of placental implantation can lead to ectopic pregnancy, with the fallopian tube being the most common site. To rule out an ectopic pregnancy, endometrial curettings should ideally be examined grossly and histologically. An intrauterine pregnancy should not be diagnosed on the basis of mature chorionic villi fragments, remote implantation site nodule, or sole presence of decidua and gestational endometrium. In early spontaneous pregnancy loss, histologic findings are usually not specific for a particular cause of pregnancy loss; karyotypic abnormalities are present in 50% to 75% of these specimens, particularly in the setting of recurrent pregnancy loss. In the setting of late pregnancy loss with a normal fetus, inflammatory abruption, the pathologic correlate of cervical incompetence, should be strongly considered.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/B9780323447324000297; http://dx.doi.org/10.1016/b978-0-323-44732-4.00029-7; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85050496601&origin=inward; https://linkinghub.elsevier.com/retrieve/pii/B9780323447324000297; https://dx.doi.org/10.1016/b978-0-323-44732-4.00029-7
Elsevier BV
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