Anatomical and histological considerations of placenta vascular diseases with implications in forensic medicine

Placenta, as a highly specialized organ in connecting the maternal and fetal organism, is frequently affected by a specific vascular pathology. The correlation between the macroscopic and the microscopic aspects of the fetal placenta vascularization together with the appearance of fibrin deposits is used to determine the pathological cause of death. Different studies suggest the hypothesis of precocious development of fibrin deposits during pregnancy, due to some immune-like reactions or due to the circulatory variations in the villous territory. The present research was realized on 467 placentas - out of 467 placentas collected in the past 10 years, 287 were from term births, 98 from premature births and 82 from abortions. The fibrin deposits in the placenta resulting from abortion can also be interpreted as alterations caused by the same circulatory variable conditions. In the therapeutic abortion, the placental fragments do not contain fibrin deposits. The correct approach of the macroscopic exam in the vascular pathology, accompanied by the recognition of the microscopic changes in the placenta, contributes to determine the cause of abortion, the premature birth or the term birth, followed by the death of the fetus and/or the mother. The study assesses the macroscopic and microscopic aspects of the vascular pathology at the placental level in cases with medical and legal implications. Our study also reported these placental aspects in aborted fetuses or in cases of intrauterine deaths, for various reasons considered forensic cases.