Placental histopathologic features in patients with thrombophilic mutations

Maria Rosaria Raspollinia, Esther Olivab & Drucilla J. Roberts MDb*a Department of Human Pathology and Oncology, University of Florence School of Medicine, Florence, Italyb Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA† Correspondence: Drucilla J. Roberts, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA, +617 724 1415, +617 726 7474 djroberts@partners.orgThe purpose of this article is to review the histopathologic findings in the placenta of women with a known thrombophilic mutation. The findings range from normal to severe pathologic features including decidual vasculopathy, placental infarctions, syncytial knotting, maternal floor infarction, fetal thrombotic vasculopathy, vasculitis, and chronic villitis. They are, however, not pathognomonic of thrombophilic states, nor are necessarily markers of perinatal damage. The prospective evaluation of cases with known thrombophilic mutations and the application of tissue microarray examination of the placenta may allow identification of major histopathologic features and molecular parameters associated with maternal and/or fetal thrombophilic states. This may assist clinicians in their consultation with patients and optimize management in future pregnancies.