Pathologic Findings -- Complications of Pregnancy


The stillborn fetus, estimated to have been 19 weeks by ultrasound and LMP, was 14-15 weeks by morphometric measurements and weighed 66 gm. No congenital anomalies were noted. However, morphologic abnormalities consistent with deformation included contractures of the elbow and wrist, varus deformities of the feet, displaced thumb, and flattened upturned nose. Autopsy findings in the placenta included focal infarcts involving approximately 30% of placental volume. The 79 gm placenta measured 10 x 5 x 2.5 cm. A 29 cm long umbilical cord had three vessels. The fetal membranes were thin and translucent.

Microscopically, the placenta revealed decidual arterial atherosis (characterized by intimal foamy macrophages in arterioles), arteriolar fibrinoid necrosis, placental dysmaturity (increased syncytial knotting, decreased villous size) and areas of villous infarction. In the fetus, thymic lymphocyte depletion was noted, and there was extramedullary hematopoiesis seen in adrenals, stomach, and lung.



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