Inflammatory lesions in placental pathology

Area of Science:

• Obstetrics and Gynecology
• Perinatal Pathology
• Neonatology

Background:

• Placental inflammatory lesions are critical indicators of fetal and neonatal morbidity and mortality.
• These lesions are categorized as acute (microorganism-induced) or chronic (immune-mediated).
• The Amsterdam International Consensus Group has established a diagnostic framework and criteria for placental lesions.

Purpose of the Study:

• To review the significance and classification of placental inflammatory lesions.
• To highlight the diagnostic criteria and implications of chorioamnionitis and chronic inflammatory lesions.
• To emphasize the role of placental pathology in understanding intrauterine conditions and predicting outcomes.

Main Methods:

• Review of established diagnostic criteria for placental inflammatory lesions.
• Classification of lesions into acute (e.g., chorioamnionitis) and chronic (e.g., villitis of unknown etiology) types.
• Discussion of the association between maternal and fetal inflammatory responses and clinical outcomes.

Main Results:

• Chorioamnionitis, characterized by neutrophil infiltration, is the most common placental pathology and represents acute inflammation.
• Fetal inflammatory response is linked to increased neonatal mortality and morbidity.
• Chronic inflammatory lesions like villitis of unknown etiology and chronic histiocytic intervillositis are associated with fetal demise and growth restriction.

Conclusions:

• Placental inflammatory lesions provide crucial insights into intrauterine conditions.
• Accurate diagnosis and understanding of these lesions guide treatment and improve prognostication.
• Further research into the etiology of chronic inflammatory lesions, potentially involving maternal immune responses, is warranted.