From the Research
Parenchymal infarction is the most likely placental finding in fetal demise due to pre-eclampsia. Pre-eclampsia is characterized by maternal hypertension and proteinuria, which leads to uteroplacental vascular insufficiency, as noted in studies such as 1. This vascular insufficiency causes reduced blood flow to the placenta, resulting in ischemia and subsequent infarction of placental tissue. These infarctions appear as wedge-shaped areas of necrosis in the placental parenchyma and can vary in size and number depending on the severity of the pre-eclampsia. The pathophysiology of pre-eclampsia involves impaired placental perfusion and subsequent placental ischemia, which results in the elaboration of numerous factors contributing to maternal endothelial and cardiovascular dysfunction, as discussed in 2.
Key points to consider include:
- Pre-eclampsia leads to uteroplacental vascular insufficiency
- Reduced blood flow to the placenta results in ischemia and infarction
- Parenchymal infarctions are directly related to the underlying pathophysiology of pre-eclampsia
- These infarctions can compromise placental function, leading to fetal growth restriction and potentially fetal demise, as seen in cases like the one described in 3
- Avascular villi can be seen in other conditions, but parenchymal infarctions are the hallmark lesion in pre-eclampsia
The most recent and highest quality studies, such as 3, support the notion that parenchymal infarction is a critical placental finding in the context of fetal demise due to pre-eclampsia, emphasizing the importance of understanding the pathophysiology of the disease for effective management.