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Updated: Feb 6, 2026

Author Spotlight: Advancing Spectral Characterization of Physiological and Malperfused Tissues
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Author Spotlight: Advancing Spectral Characterization of Physiological and Malperfused Tissues

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Fetal vascular malperfusion, an update.

Raymond W Redline1,2, Sanjita Ravishankar1,2

  • 1Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
|August 22, 2018
PubMed
Summary

Fetal vascular malperfusion, often caused by umbilical cord issues, signifies reduced fetal blood flow to the placenta. Severe cases increase risks for fetal growth restriction, brain injury, and stillbirth, though recurrence is uncommon.

Keywords:
Cerebral palsyfetal thrombotic vasculopathyfetal vascular malperfusionneonatal encephalopathyperinatal strokeplacental pathologyumbilical cord

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Placental Pathology

Background:

  • Fetal vascular malperfusion describes placental lesions indicating impaired fetal blood flow.
  • Umbilical cord obstruction is a primary cause, leading to stasis, ischemia, and thrombosis.
  • Maternal diabetes, fetal cardiac issues, and thrombophilias are additional contributing factors.

Purpose of the Study:

  • To define fetal vascular malperfusion and its common etiologies.
  • To highlight the association between severe malperfusion and adverse pregnancy outcomes.
  • To discuss the recurrence risk in subsequent pregnancies.

Main Methods:

  • Review of placental pathology terminology and classification.
  • Analysis of etiological factors contributing to fetal vascular malperfusion.
  • Evaluation of clinical outcomes associated with severe placental malperfusion.

Main Results:

  • Fetal vascular malperfusion is linked to reduced villous parenchymal perfusion.
  • Umbilical cord obstruction is the most frequent cause.
  • Severe malperfusion is a significant risk factor for fetal growth restriction, CNS injury, and stillbirth.

Conclusions:

  • Fetal vascular malperfusion is a critical indicator of placental dysfunction.
  • Prompt identification and management are essential for mitigating adverse pregnancy outcomes.
  • The overall recurrence risk for subsequent pregnancies is low.