Chronic villitis, chronic chorioamnionitis, and maternal floor infarction

Area of Science:

• Reproductive immunology
• Perinatal pathology

Background:

• Chronic inflammatory infiltrates in the human placenta are less common than acute inflammation.
• Villitis, inflammation of placental villi, is frequently associated with maternal infections but often has an unknown etiology.
• Chronic chorioamnionitis and maternal floor infarction are related placental conditions with significant implications for pregnancy outcomes.

Purpose of the Study:

• To review the features of villous inflammatory infiltrates and associated villous changes.
• To discuss potential infectious etiologies of villitis and chronic chorioamnionitis.
• To describe maternal floor infarction and its association with adverse pregnancy outcomes.

Main Methods:

• Review of existing literature on placental inflammation and pathology.
• Analysis of villous inflammatory patterns and associated villous changes.
• Correlation of placental findings with maternal infections and pregnancy outcomes.

Main Results:

• Villitis, while often linked to infections, frequently lacks a specific identified pathogen.
• Chronic chorioamnionitis accompanies villitis and various infections, yet many cases remain without a determined cause.
• Maternal floor infarction, characterized by fibrin deposition, is associated with intrauterine growth retardation, fetal demise, and recurrence.

Conclusions:

• The etiology of the majority of villitides is unknown, suggesting potential unrecognized pathogens or abnormal immune responses.
• While some chronic placental inflammations are linked to specific infections, many cases remain undiagnosed.
• Maternal floor infarction is a distinct pathological entity with significant reproductive consequences.