Am J Perinatol 1997; 14(8): 435-441
DOI: 10.1055/s-2007-994176
ORIGINAL ARTICLE

© 1997 by Thieme Medical Publishers, Inc.

Placental Pathology and Antiphospholipid Antibodies: A Descriptive Study

Carolyn M. Salafia1 , F. Susan Cowchock2 , 3
  • 1Department of Pathology, Montefiore Medical Center, Bronx, New York
  • 2Department of Medicine Thomas Jefferson University Medical School, Philadelphia, Pennsylvania
  • 3Department of Obstetrics and Gynecology, Thomas Jefferson University Medical School, Philadelphia, Pennsylvania
Further Information

Publication History

Publication Date:
04 March 2008 (online)

ABSTRACT

We described placental pathology in antiphospholipid antibody (APL) syndrome, APL and no history of recurrent pregnancy loss, and in treated and untreated pregnancies of APL syndrome. Thirty-nine pregnancies of 28 patients were studied: 23 placentas delivered from 23 women with APL (13 with APL syndrome and 10 with serological APL); 8 untreated miscarriages before APL diagnosis from 6 of the 13 patients with APL syndrome and 1 of 10 with serological APL; and 8 miscarriages by 5 additional women before APL syndrome diagnosis. Histopathology was reviewed by a pathologist blinded except to gestational age. Contingency tables and analysis of variance (ANOVA) considered p < 0.05 significant. Comparing the placentas delivered at >18 weeks' gestation, excessive perivillous coagulation, avascular terminal villi, and chronic villitis/uteroplacental vasculitis tended to be more common in treated APL syndrome than serological APL cases (p = 0.07). Of the 16 miscarriages before diagnosis of APL, 11 were lost at <18 weeks' gestation. None had pathology typical of APL, but 4 of 11 (36%) had chronic intervillositis. Five of 16 miscarriages before the diagnosis of APL were miscarried between 18-22 weeks. Three of 5 (60%) miscarried after 18 weeks had multifocal uteroplacental thromboses, compared to 6 of 1 3 (46%) treated pregnancies with APL syndrome and 0 of 10 cases with serological APL.