Recurrent reproductive failure due to severe placental villitis of unknown etiology

A case is reported of recurrent reproductive failure due to a severe placental villitis of unknow etiology. Five successive pregnancies ended in four unexpected third-trimester deaths in utero and one live birth at 37 weeks' gestation. This infant of the fourth pregnancy showed severe intrauterine growth retardation but no other stigmata of chronic infection. The placentas of the last three pregnancies showed marked focal chronic parenchymal inflammation with widespread necrosis, villous vasculitis and a lymphocytic deciduitis of the maternal floor. Microbiologic, serologic and electron microscopic techniques variously employed on maternal, fetal and placental specimens failed to demonstrate a possible causative agent although the placental inflammatory pattern was strongly suggestive of recurrent infection.