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This is a Literature Review study.

October 2, 2025Open Access

Placental morphogenesis and its role in the development of pregnancy complications: Contemporary classifications and clinical significance (A literature review)

Key Points

The review identifies six stages of physiological placental morphogenesis, critical for understanding pregnancy development.
Key pathological patterns, including maternal and fetal vascular malperfusion, are linked to perinatal complications like IUGR and HIE.
Research highlights the importance of modern classifications for timely diagnosis and improved perinatal outcomes in complicated pregnancies.
Advances in placental morphogenesis understanding may reduce neonatal morbidity and mortality through early intervention.

Abstract

Relevance: The placenta plays a crucial role in ensuring normal pregnancy progression by facilitating metabolic exchange, hormonal regulation, and fetal immune protection. Abnormalities in its development and structure are associated with severe perinatal complications, including intrauterine growth restriction (IUGR), congenital malformations (CM), and hypoxic-ischemic encephalopathy (HIE).The study aimed to systematize current knowledge on the stages of placental morphogenesis, modern classifications of placental pathology, and their clinical implications in complicated pregnancies.Materials and Methods: This review analyzed 41 peer-reviewed publications selected from PubMed, Scopus, and eLibrary (2015–2024) using keywords: “placental morphogenesis,” “Amsterdam classification,” “IUGR,” “HIE,” and “villitis.” Inclusion criteria: (1) studies with histopathological data; (2) clear clinical-pathological correlations; (3) adherence to modern classifications (Amsterdam 2021). Exclusion criteria: case reports and pre-2015 literature. PRISMA-guided screening of 78 initially identified records yielded 41 relevant sources.Results: The review outlined six key stages of physiological placental morphogenesis and identified four major pathological patterns: maternal and fetal vascular malperfusion, acute chorioamnionitis, and chronic villitis. Their morphological characteristics, pathogenesis, and clinical correlations with perinatal complications (e.g., IUGR, CM, HIE) have been critically reviewed.Conclusion: Modern classifications of placental pathology and advances in understanding morphogenesis are critical for early diagnosis and prevention of pregnancy complications. Timely identification of histological abnormalities can improve perinatal outcomes and reduce neonatal morbidity and mortality. Further research is needed to refine clinical monitoring protocols and therapeutic strategies.

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