Pathology
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Fetopathology and developmental pathology of the embryo and fetus
Marta Ježová, Josef Feit et al.
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Placenta and major chromosomal abnormalities
Introduction

Placentas in late abortions associated with chromosomal abnormalities (trisomy 13, 18, 21 and monosomy X in particular) may show abnormal gross or histologic features.

Macroscopic appearance

The placenta may be either large or small for gestational age. Rarely cysts may be grossly recognizable.

Pictures

Placenta in trisomy 13, pregnancy termination at 23 w.g.; placenta with scattered large vesicles: Placenta, syndrome Patau, Macro, autopsy (72868) Placenta, syndrome Patau, Macro, autopsy (72869)

Histology
  • immature villi.
  • dysmorphic features of chorionic villi include cystic villi, irregular villous outline, trophoblastic inclusions, stromal karyomegaly, aberrant capillary pattern, chorangiosis (hypercapillarization)
  • Rare cases mimicking partial mole were described in association with trisomy 13. A population of large hydropic poorly vascularized villi is present. Trophoblastic hyperplasia is absent. The risk of persisting trophoblastic disease is not increased.

These features are not neither specific or constant in chromosomal abnormalities and cannot be used for diagnosis as the only sign.

Pictures

Placenta mimicking partial mole, huge hydropic villi, poor vascularization, no trophoblastic hyperplasia, normal villi: Placenta, trisomy 13, HE 20x (72806) Placenta, trisomy 13, HE 40x (72807)

Placenta in trisomy 21, 40-week stillborn infant, retardation of villous maturation, aberrant vasculary pattern, choriangiosis: Dystrophic placenta, Down syndrome, HE 20x (72866)