Delayed villous maturation with and without fetal demise: A case report of three successive pregnancies

This case study examined three subsequent pregnancies with delayed villous maturation (DVM) resulting in infants either large for gestational age (LGA) or appropriate for gestational age. A perinatal pathologist histopathologically reviewed the placentas using the Amsterdam Consensus Criteria. The first pregnancy ended in a term fetal demise of an LGA infant due to severe asphyxia associated with idiopathic DVM. Due to the history of stillbirth and DVM, labor was induced at 36 weeks of gestation in the second and third pregnancies. The second and third pregnancies resulted in liveborn infants with varying weight profiles despite similar placental lesions. All three placentas showed DVM with positive CD15 immunostaining. Additionally, the second and third placentas exhibited villitis of unknown etiology. This case report underscores the importance of structured histologic placental examination following complicated pregnancies by a perinatal pathologist.