Clinical correlates of histopathological entities of the placenta

General and allied health practitioners caring for pregnant women and neonates often encounter placental histopathological reports with esoteric diagnostic entities of contentious clinical significance such as chronic villitis, massive perivillous fibrin deposition, chronic histiocytic intervillositis, materno-fetal vascular malperfusion and delayed villous maturation. These lesions may recur in subsequent pregnancies.

The aim of this article is to review the status quo of placental pathology and research with an emphasis on clinical management implications for some of these most often reported but less understood recurrent clinicopathological entities of the placenta. An update on the current nomenclature and classification of placental conditions is also provided.

When reported adequately and interpreted correctly, placental histopathology provides useful information that may explain adverse pregnancy outcomes and guides further management of the mother, newborn or future pregnancy. Empirical treatments for immune-mediated placental conditions with prednisolone, aspirin, heparin and intravenous immunoglobulins have been reported. However, evidence-based guidelines for management of these conditions are lacking, and more research, including clinical trials, is in order.