The Placenta and Umbilical Cord

  • T. Yee Khong


The placenta and extraplacental membranes are an apposition of fetal and maternal tissues for the purposes of physiological exchange. The placenta has a finite life span and is the body’s largest biopsy and yet its examination is often neglected, even in cases of fetal and neonatal deaths, of sick and premature neonates and some maternal complications of pregnancy. This is perplexing because its function is embodied in its definition. It may be that placental pathology is complex since the organ is evolving rapidly over a short period of time, or that the lesions found may be quantitative rather than qualitative. The response of the placenta to injury is limited and there is a need to correlate the macroscopic and microscopic findings with clinical and laboratory investigations.


Umbilical Cord Obstet Gynecol Intrauterine Growth Restriction Spiral Artery Intervillous Space 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Abramowsky CR, Vegas ME, Swinehart G, Gyves MT (1980) Decidual vasculopathy of the placenta in lupus erythematosus. N Engl J Med 303:668–672PubMedCrossRefGoogle Scholar
  2. Ackerman J, Gilbert-Barness E (1997) Malignancy metastatic to the products of conception: a case report with literature review. Pediatr Pathol Lab Med 17:577–586PubMedCrossRefGoogle Scholar
  3. Althabe O, Labarrere C (1985) Chronic villitis of unknown aetiology and intrauterine growth-retarded infants of normal and low ponderai index. Placenta 6:369–373PubMedCrossRefGoogle Scholar
  4. Altshuler G (1984) Chorangiosis. An important sign of neonatal morbidity and mortality. Arch Pathol Lab Med 108:71–74PubMedGoogle Scholar
  5. Altshuler G, Hyde S (1989) Meconium induced vasoconstriction: a potential cause of cerebral and other fetal hypoperfusion and of poor pregnancy outcome. J Child Neurol 4:137–142PubMedCrossRefGoogle Scholar
  6. Altshuler G, Arizawa M, Molnar-Nadasdy G (1992) Meconium-induced umbilical cord vascular necrosis and ulceration: a potential link between the placenta and poor pregnancy outcome. Obstet Gynecol 79:760–766PubMedGoogle Scholar
  7. Andres RL, Kuyper W, Resnik R, Piacquadio KM, Benirschke K (1990) The association of maternal floor infarction of the placenta with adverse perinatal outcome. Am J Obstet Gynecol 163:935–938PubMedGoogle Scholar
  8. Arias F, Victoria A, Cho K, Kraus F (1997) Placental histology and clinical characteristics of patients with preterm premature rupture of membranes. Obstet Gynecol 89:265–271PubMedCrossRefGoogle Scholar
  9. Baill IC, Witter FR (1990) Sickle trait and its association with birthweight and urinary tract infections in pregnancy. Int J Gynaecol Obstet 33:19–21PubMedCrossRefGoogle Scholar
  10. Baill IC, Moore GW, Hendrick LA (1989) Abscess of allantoic duct remnant. Am J Obstet Gynecol 161:334–336PubMedGoogle Scholar
  11. Bain C, Elliot BW (1976) Fetal distress in the first stage of labour associated with early fetal heart decelerations and a short umbilical cord. Aust NZ J Obstet Gynaecol 16:51–56CrossRefGoogle Scholar
  12. Bajoria R, Wigglesworth J, Fisk NM (1995) Angioarchitecture of monochorionic placentae in relation to the twin-twin transfusion syndrome. Am J Obstet Gynecol 172:856–863PubMedCrossRefGoogle Scholar
  13. Baldwin VJ (1994) Pathology of multiple pregnancy. Springer-Verlag, New YorkCrossRefGoogle Scholar
  14. Barth WHJr, Genest DR, Riley LE et al. (1996) Uterine arcuate artery Doppler and decidual intravascular pathology in pregnancies complicated by type I diabetes melitus. Ultrasound Obstet Gynecol 8:98–103PubMedCrossRefGoogle Scholar
  15. Bendon RW (1995) Twin transfusion: pathological studies of the monochorionic placenta in liveborn twins and of the perinatal autopsy in monochorionic twin pairs. Pediatr Pathol Lab Med 15:363–376PubMedCrossRefGoogle Scholar
  16. Bendon RW, Ray MB (1986) The pathologic findings of the fetal membranes in very prolonged amniotic fluid leakage. Arch Pathol Lab Med 110:47–50PubMedGoogle Scholar
  17. Bendon RW, Tyson RW, Baldwin VJ et al. (1991) Umbilical cord ulceration and intestinal atresia: a new association? Am J Obstet Gynecol 164:582–6PubMedGoogle Scholar
  18. Benirschke K, Kaufmann P (1995) The pathology of the human placenta, 3rd edition. Springer-Verlag, New YorkGoogle Scholar
  19. Berg TG, Rayburn WF (1995) Umbilical cord length and acid-base balance at delivery. J Reprod Med 40:9–12PubMedGoogle Scholar
  20. Birkenfeld A, Mordei N, Okon E (1989) Direct demonstration of iron in a placenta in a case of β-thalassemia major. Am J Obstet Gynecol 160:562–563PubMedGoogle Scholar
  21. Björk O, Persson B (1982) Placental changes in relation to the degree of metabolic control in diabetes mellitus. Placenta 3:367–78PubMedCrossRefGoogle Scholar
  22. Björk O, Persson B, Stangenberg M, Václavínková V (1984) Spiral artery lesions in relation to metabolic control in diabetes mellitus. Acta Obstet Gynecol Scand 63:123–127PubMedCrossRefGoogle Scholar
  23. Blanc WA (1981) Pathology of the placenta, membranes and umbilical cord in bacterial, fungal and viral infections in man. In: Naeye RL, Kissane JM, Kaufman N (eds) Perinatal disease. Williams and Wilkins, Baltimore, pp 67–132Google Scholar
  24. Blickstein I, Shoham-Schwartz Z, Lancet M (1987) Predisposing factors in the formation of true knots of the umbilical cord — analysis of morphometric and perinatal data. Int J Gynaecol Obstet 25:395–398PubMedCrossRefGoogle Scholar
  25. Booth VJ, Nelson KB, Dambrosia JM, Grether JK (1997) What factors influence whether placentae are submitted for pathologic examination? Am J Obstet Gynecol 176:567–571PubMedCrossRefGoogle Scholar
  26. Bourke WG, Clarke TA, Mathews TG, O’Halpin D, Donoghue VB (1993) Isolated single umbilical artery — the case for routine renal screening. Arch Dis Child 68:600–601PubMedCrossRefGoogle Scholar
  27. Boyd JD, Hamilton WJ (1970) The human placenta. Heffer and Sons, CambridgeGoogle Scholar
  28. Boyd PA (1984) Quantitative structure of the normal human placenta from ten weeks of gestation to term. Early Hum Dev 9:297–307PubMedCrossRefGoogle Scholar
  29. Boyd PA, Scott A (1985) Quantitative structural studies in human placentae associated with pre-eclampsia, essential hype-tension and intrauterine growth retardation. Br J Obstet Gynaecol 92:714–721PubMedCrossRefGoogle Scholar
  30. Boyd PA, Brown R, Stewart W (1980) Quantitative structural differences within the normal term human placenta: a pilot study. Placenta 1:337–344PubMedCrossRefGoogle Scholar
  31. Boyd PA, Scott A, Keeling JW (1986) Quantitative structural studies on placentae from pregnancies complicated by diabetes mellitus. Br J Obstet Gynaecol 93:31–35PubMedCrossRefGoogle Scholar
  32. Bruyniks N, Khong TY, Leong R (1988) Relation of site of umbilical cord insertion and birth weight. J Obstet Gynaecol 9:34–35CrossRefGoogle Scholar
  33. Bulmer JN, Rasheed FN, Francis N, Morrison L, Greenwood BM. (1993a) Placental malaria. I. Pathological classification of placental malaria. Histopathology 22:211–218PubMedCrossRefGoogle Scholar
  34. Bulmer JN, Rasheed FN, Morrison L, Francis N, Greenwood BM. (1993b) Placental malaria. II. A semi-quantitative investigation of the pathological features. Histopathology 22:219–225PubMedCrossRefGoogle Scholar
  35. Burton GJ, Palmer ME, Dalton KJ (1989) Morphometric differences between the placental vasculature of non-smokers, smokers and ex-smokers. Br J Obstet Gynaecol 96:907–915PubMedCrossRefGoogle Scholar
  36. Carter AM (1997) When is the maternal placental circulation established in man? Placenta 18:83–87PubMedCrossRefGoogle Scholar
  37. Chandwani S, Greco MA, Krasinski K, Borkowsky W. (1992) Pathology of the placenta in HIV-1 infection. Prog AIDS Pathol 3:65–81PubMedGoogle Scholar
  38. Chasnoff IJ, Fletcher MA (1977) True knot of the umbilical cord. Am J Obstet Gynecol 127:425–427PubMedGoogle Scholar
  39. Clarson C, Tevaarwerk GJM, Harding PGR, Chance GW, Haust MD (1989) Placental weight in diabetic pregnancies. Placenta 10:275–281PubMedCrossRefGoogle Scholar
  40. Clausen I (1989) Umbilical cord anomalies and antenatal fetal deaths. Obstet Gynecol Surv 44:841–845PubMedCrossRefGoogle Scholar
  41. Cook V, Weeks J, Brown J, Bendon R (1995) Umbilical artery obstruction and fetoplacental thromboembolism. Obstet Gynecol 85:870–872PubMedCrossRefGoogle Scholar
  42. Costoya AL, Leontic EA, Rosenberg HG, Delgado MA (1980) Morphological study of placental terminal villi in intrahepatic cholestasis of pregnancy: histochemistry, light and electron microscopy. Placenta 1:361–368PubMedCrossRefGoogle Scholar
  43. Craver RD, Baldwin VJ (1992) Necrotizing funisitis. Obstet Gynecol 79:64–70PubMedGoogle Scholar
  44. Danskin FH, Neilson JP (1989) Twin-to-twin transfusion syndrome: What are appropriate criteria? Am J Obstet Gynecol 161:365–369PubMedGoogle Scholar
  45. Davey DA, MacGillivray I (1988) The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 158:892–898PubMedGoogle Scholar
  46. Daw EG (1992) Fetus vanescens, fetus compressus and fetus papyraceus. J Obstet Gynaecol 12:375–376CrossRefGoogle Scholar
  47. Denmead DT, Ariagno RL, Carson SH, Benirschke KB (1987) Placental pathology is not predictive for sudden infant death syndrome (SIDS). Am J Perinatol 4:308–312PubMedCrossRefGoogle Scholar
  48. Dommisse J, Tiltman AJ (1992) Placental bed biopsies in placental abruption. Br J Obstet Gynaecol 99:651–654PubMedCrossRefGoogle Scholar
  49. Doss BJ, Greene MF, Hill J et al. (1995) Massive chronic inter-villositis associated with recurrent abortions. Hum Pathol 26:1245–1251PubMedCrossRefGoogle Scholar
  50. Dougall A, Baird CH (1987) Vasa praevia — report of three cases and review of literature. Br J Obstet Gynaecol 94:712–715PubMedCrossRefGoogle Scholar
  51. Ebbesen P, Toth F, Aboagye-Mathiesen G et al. (1994) Vertical transmission of HIV: possible mechanisms and placental response. Trophoblast Res 8:1–17Google Scholar
  52. Finberg HJ (1992) The “twin peak” sign: reliable evidence of dichorionic twinning. J Ultrasound Med 11:571–577PubMedGoogle Scholar
  53. Fisk NM, Bryan E (1993) Routine prenatal determination of chorionicity in multiple gestation: a plea to the obstetrician. Br J Obstet Gynaecol 100:975–977PubMedCrossRefGoogle Scholar
  54. Fletcher S (1993) Chirality in the umbilical cord. Br J Obstet Gynaecol 100:234–236PubMedCrossRefGoogle Scholar
  55. Fox H (1967) The incidence and significance of nucleated erythrocytes in the foetal vessels of the mature human placenta. J Obstet Gynaecol Br Commonw 74:40–43PubMedCrossRefGoogle Scholar
  56. Fox H (1997) Pathology of the placenta, 2nd edition. W.B. Saunders, LondonGoogle Scholar
  57. Fox H, Langley FA (1971) Leucocytic infiltration of the placenta and umbilical cord: a clinico-pathologic study. Obstet Gynecol 37:451–458PubMedGoogle Scholar
  58. Fries MH, Goldstein RB, Kilpatrick SJ et al. (1993) The role of velamentous cord insertion in the etiology of twin-twin transfusion syndrome. Obstet Gynecol 81:569–574PubMedGoogle Scholar
  59. Garcia AGP (1982) Placental morphology of low birth weight infants at term: gross and microscopic study of 50 cases. Contrib Gynecol Obstet 9:100–112PubMedGoogle Scholar
  60. Garite TJ, Freeman RK (1982) Chorioamnionitis in the preterm gestation. Obstet Gynecol 59:538–545Google Scholar
  61. Geirsson RT, Ogston SA, Patel NB, Christie AD (1985) Growth of total intrauterine, intra-amniotic and placental volume in normal singleton pregnancy measured by ultrasound. Br J Obstet Gynaecol 92:46–53PubMedCrossRefGoogle Scholar
  62. Genest DR (1992) Estimating the time of death in stillborn fetuses. II. Histologic evaluation of the placenta; a study of 71 stillborns. Obstet Gynecol 80:585–592PubMedGoogle Scholar
  63. Gersell DJ (1993) Chronic villitis, chronic chorioamnionitis, and maternal floor infarction. Sem Diagn Pathol 10:251–266Google Scholar
  64. Gersell DJ, Phillips NJ, Beckerman K (1991) Chronic chorioamnionitis; a clinicopathologic study of 17 cases. Int J Gynecol Pathol 10:217–229PubMedCrossRefGoogle Scholar
  65. Gilbert WM, Lafferty CM, Benirschke K, Resnik R (1990) Lack of specific placental abnormality associated with cocaine use. Am J Obstet Gynecol 163:998–999PubMedGoogle Scholar
  66. Gilbert WM, Davis SE, Kaplan C et al. (1991) Morbidity associated with prenatal disruption of the dividing membrane in twin gestations. Obstet Gynecol 78:623–630PubMedGoogle Scholar
  67. Giles WB, Trudinger BJ, Baird PJ (1985) Fetal umbilical artery flow velocity waveforms and placental resistance: pathologic correlation. Br J Obstet Gynaecol 92:31–38PubMedCrossRefGoogle Scholar
  68. Goddijnwessel TAW, Wouters MGAJ, Vandermolen EF et al. (1996) Hyperhomocysteinemia — a risk factor for placental abruption or infarction. Eur J Obstet Gynecol Reprod Biol 66:23–29CrossRefGoogle Scholar
  69. Godfrey KM, Redman CWG, Barker DJP, Osmond C (1991) The effect of maternal anaemia and iron deficiency on the ratio of fetal weight to placental weight. Br J Obstet Gynaecol 98:886–891PubMedCrossRefGoogle Scholar
  70. Gruenwald P (1975) The supply line of the fetus; definitions relating to fetal growth. In: Gruenwald P (ed) The placenta and its maternal supply line. MTP, Lancaster, pp 1–7Google Scholar
  71. Hankins GDV, Snyder RR, Hauth JC, Gilstrap LC 3rd, Hammond T (1987) Nuchal cords and neonatal outcome. Obstet Gynecol 70:687–691PubMedGoogle Scholar
  72. Harris BA Jr, Gore H, Flowers CE (1985) Peripheral placental separation: a possible relationship to premature labour. Obstet Gynecol 66:774–778PubMedGoogle Scholar
  73. Harris RD, Cho C, Wells WA (1996) Sonography of the placenta with emphasis on pathological correlation. Sem Ultrasound CT MR 17:66–89CrossRefGoogle Scholar
  74. Haust MD (1981) Maternal diabetes mellitus — effects of the fetus and placenta. Monogr Pathol 22:201–285PubMedGoogle Scholar
  75. Heifetz SA (1984) Strangulation of the umbilical cord by amniotic bands: report of 6 cases and literature review. Pediatr Pathol 2:285–304PubMedCrossRefGoogle Scholar
  76. Heifetz SA (1988) Thrombosis of the umbilical cord: analysis of 52 cases and literature review. Pediatr Pathol 8:37–54PubMedCrossRefGoogle Scholar
  77. Hillstrom MM, Brown DL, Wilkins-Haug L, Genest DR (1995) Sonographic appearance of placental hydrops associated with Beckwith-Wiedemann syndrome. J Ultrasound Med 14:61–64PubMedGoogle Scholar
  78. Houlihan CM, Knuppel RA (1994) Meconium-stained amniotic fluid: current controversies. J Reprod Med 39:888–898PubMedGoogle Scholar
  79. Hurley VA, Beischer NA (1987) Placenta membranacea. Case reports. Br J Obstet Gynaecol 94:798–802PubMedCrossRefGoogle Scholar
  80. Hyde S, Smotherman J, Moore JI, Altshuler G (1989) A model of bacterially induced umbilical vein spasm, relevant to fetal hypoperfusion. Obstet Gynecol 73:966–970PubMedCrossRefGoogle Scholar
  81. Ismail MR, Ordi J, Menendez C et al. (2000) Placental pathology in malaria: a histological, immunohistochemical and quan-titive study. Hum Pathol 31:85–93PubMedCrossRefGoogle Scholar
  82. Jackson MR, Walsh AJ, Morrow RJ et al. (1995) Reduced placental villous tree elaboration in small-for-gestational-age newborn pregnancies: relationship with umbilical artery Doppler waveforms. Am J Obstet Gynecol 172:518–525PubMedCrossRefGoogle Scholar
  83. Jacques SM, Qureshi F (1993) Chronic intervillositis of the placenta. Arch Pathol Lab Med 117:1032–1035PubMedGoogle Scholar
  84. Jacques SM, Qureshi F (1998) Chronic chorioamnionitis: a clin-icopathologic and immunohistochemical study. Hum Pathol 29:1457–1461PubMedCrossRefGoogle Scholar
  85. Jacques SM, Qureshi F, Trent VS, Ramirez NC (1996) Placenta accreta: mild cases diagnosed by placental examination. Int J Gynecol Pathol 15:28–33PubMedCrossRefGoogle Scholar
  86. Jaffe R, Jauniaux E, Hustin J (1997) Maternal circulation in the first-trimester human placenta — myth or reality? Am J Obstet Gynecol 176:695–705PubMedCrossRefGoogle Scholar
  87. Jauniaux E, Zucker M, Meuris S et al. (1988) Chorangiocarcinoma: an unusual tumour of the placenta. The missing link? Placenta 9:607–613PubMedCrossRefGoogle Scholar
  88. Jones CJP, Lendon M, Chawner LE, Jauniaux E (1990) Ultrastructure of the human placenta in metabolic storage disease. Placenta 11:395–411PubMedCrossRefGoogle Scholar
  89. Jones KL (1988) Smith’s recognizable patterns of human malformation. WB Saunders, LondonGoogle Scholar
  90. Jones TB, Sorokin Y, Bhatia R, Zador IE, Bottoms SF. (1993) Single umbilical artery: accurate diagnosis? Am J Obstet Gynecol 169:538–540PubMedGoogle Scholar
  91. Kalousek DK (1994) Current topic: Confined placental mosaicism and intrauterine fetal development. Placenta 15:219–230PubMedCrossRefGoogle Scholar
  92. Kåregård M, Gennser G (1986) Incidence and recurrence rate of abruptio placentae in Sweden. Obstet Gynecol 67:523–528PubMedGoogle Scholar
  93. Kaufmann P (1982) Development and differentiation of the human placental villous tree. Biblio Anat 22:29–39Google Scholar
  94. Khong TY (1987) Immunohistologic study of the leukocytic infiltrate in maternal uterine tissues in normal and preeclamptic pregnancies at term. Am J Reprod Immunol 15:1–8Google Scholar
  95. Khong TY (1991a) Acute atherosis in pregnancies complicated by hypertension, growth retardation, and diabetes mellitus. Arch Pathol Lab Med 115:722–725PubMedGoogle Scholar
  96. Khong TY (1991b) The Robertson-Brosens-Dixon hypothesis. Evidence for the role of haemochorial placentation in pregnancy success. Br J Obstet Gynaecol 98:1195–1199PubMedCrossRefGoogle Scholar
  97. Khong TY (1997) From delivery suite to laboratory: optimizing returns from placental examination in medico-legal defence. Aust NZ J Obstet Gynaecol 37:1–5CrossRefGoogle Scholar
  98. Khong TY, Chambers HM (1992) Alternative method of sampling placentae for the assessment of uteroplacental vasculature. J Clin Pathol 45:925–927PubMedCrossRefGoogle Scholar
  99. Khong TY, Duly SA (1989) Calcification of umbilical artery: two distinct lesions. J Clin Pathol 42:931–934PubMedCrossRefGoogle Scholar
  100. Khong TY, George K (1992) Chromosomal abnormalities associated with a single umbilical artery. Prenat Diagn 12:965–968PubMedCrossRefGoogle Scholar
  101. Khong TY, George K (1994) Maternal serum alphafetoprotein levels in chorioangiomas. Am J Perinatol 11:245–248PubMedCrossRefGoogle Scholar
  102. Khong TY, Robertson WB (1987) Placenta creta and placenta praevia creta. Placenta 8:399–409PubMedCrossRefGoogle Scholar
  103. Khong TY, Pearce JM, Robertson WB (1987) Acute atherosis in preeclampsia: maternal determinants and fetal outcome in the presence of the lesion. AmJ Obstet Gynecol 157:360–363Google Scholar
  104. Khong TY, De Wolf F, Robertson WB, Brosens I (1986) Inadequate maternal vascular response to placentation in pregnancies complicated by preeclampsia and by small-for-gestational-age infants. Br J Obstet Gynaecol 93:1049–1059PubMedCrossRefGoogle Scholar
  105. Khong TY, Sawyer IH, Heryet A (1992) An immunohistologic study of uteroplacental vessels in human pregnancy -evidence that endothelium is focally disrupted by trophoblast in preeclampsia. Am J Obstet Gynecol 167:751–756PubMedGoogle Scholar
  106. Khong TY, Staples A, Moore L, Byard RW (1993) Observer reliability in assessing villitis of unknown aetiology. J Clin Pathol 46:208–10PubMedCrossRefGoogle Scholar
  107. Khong TY, Ford WDA, Haan EA (1994) Umbilical cord ulceration in association with intestinal atresia in a child with deletion 13q and Hirschsprung’s disease. Arch Dis Child 71:212–213CrossRefGoogle Scholar
  108. Khong TY, Staples A, Bendon RW et al. (1995) Observer reliability in assessing placental maturity by histology. J Clin Pathol 48:420–423PubMedCrossRefGoogle Scholar
  109. Khudr G, Benirschke K (1972) Placental lesions in viral hepatitis. Obstet Gynecol 40:381–384PubMedGoogle Scholar
  110. Kraus FT (1997) Cerebral palsy and thrombi in placental vessels of the fetus: insights from litigation. Hum Pathol 28:246–248PubMedCrossRefGoogle Scholar
  111. Kundsin RB, Driscoll SG, Monson RR et al. (1984) Association of Ureaplasma urealyticum in the placenta with perinatal morbidity and mortality. N Engl J Med 310:941–945PubMedCrossRefGoogle Scholar
  112. Labarrere CA (1988) Review article: acute atherosis: a histolo-gopathological hallmark of immune aggression? Placenta 9:95–108PubMedCrossRefGoogle Scholar
  113. Labarrere CA, Faulk WP (1995) Maternal cells in chorionic villi from placentae of normal and abnormal pregnancies. Am J Reprod Immunol 33:54–59PubMedGoogle Scholar
  114. Labarrere CA, Mullen E (1987) Fibrinoid and trophoblastic necrosis with massive chronic intervillositis: an extreme variant of villitis of unknown etiology. Am J Reprod Immunol Microbiol 15:85–91PubMedGoogle Scholar
  115. Labarrere C, Althabe O, Telenta M (1982) Chronic villitis of unknown aetiology in placentae of idiopathic small for gestational age infants. Placenta 3:309–318PubMedCrossRefGoogle Scholar
  116. Labarrere C, Sebastiani M, Siminovich M, Torassa E, Althabe O (1985) Absence of Wharton’s jelly around the umbilical arteries: an unusual cause of perinatal mortality. Placenta 6:555–559PubMedCrossRefGoogle Scholar
  117. Lake BD (1995) Histopathological investigation of prenatal tissue samples (excluding skin). In: Reed GB, Claireaux AE, Cockburn F (eds) Diseases of the fetus and newborn. Chapman & Hall, London, pp 1089–1097Google Scholar
  118. Lage JM (1991) Placentomegaly with massive hydrops of placental stem villi, diploid DNA content, and fetal omphaloceles: possible association with Beckwith-Wiedemann syndrome. Hum Pathol 22:591–597PubMedCrossRefGoogle Scholar
  119. Langston C, Kaplan C, Macpherson T et al. (1997) Practical guidelines for examination of the placenta. Developed by the Placental Pathology Guidelines Task Force of the College of American Pathologists. Arch Path Lab Med 121:449–476PubMedGoogle Scholar
  120. Larsen LG, Clausen HV, Andersen B, Graem N (1995) A stereologic study of postmature placentae fixed by dual perfusion. Am J Obstet Gynecol 175:500–507CrossRefGoogle Scholar
  121. Larsson S, Cronberg S, Winblad S (1979) Listeriosis during pregnancy and neonatal period in Sweden 1958–1984. Acta Paediatr Scand 68:485–493CrossRefGoogle Scholar
  122. Lilja M (1991a) Infants with single umbilical artery studied in a national registry. General epidemiological characteristics. Paediatr Perinat Epidemiol 5:27–36PubMedCrossRefGoogle Scholar
  123. Lilja GMC (1991b) Single umbilical artery and maternal smoking. Br Med J 302:569–570CrossRefGoogle Scholar
  124. Lilja M (1992) Infants with single umbilical artery studied in a national registry.2. Survival and malformations in infants with single umbilical artery. Paediatr Perinat Epidemiol 6:416–422PubMedCrossRefGoogle Scholar
  125. Lin S, Shimizu I, Suehara N, Nakayama M, Aono T (1995) Uterine artery Doppler velocimetry in relation to trophoblast migration into the myometrium of the placental bed. Obstet Gynecol 85:760–765PubMedCrossRefGoogle Scholar
  126. MacGillivray I, Nylander PPS, Corney G (1975) Human multiple reproduction. W.B. Saunders, LondonGoogle Scholar
  127. Machin GA, Bamforth F (1996) Zygosity and placental anatomy in 15 consecutive sets of spontaneously conceived triplets. Am J Med Genet 61:247–252PubMedCrossRefGoogle Scholar
  128. Machin GA, Ackerman J, Gilbert-Barness E (2000) Abnormal umbilical cord coiling is associated with adverse perinatal outcomes. Ped Dev Pathol 3:462–471.CrossRefGoogle Scholar
  129. Maher JT, Conti JA (1996) A comparison of umbilical cord blood gas values between newborns with and without true knots. Obstet Gynecol 88:863–866PubMedCrossRefGoogle Scholar
  130. Mandsager NT, Bendon R, Mostello D et al. (1994) Maternal floor infarction of the placenta: prenatal diagnosis and clinical significance. Obstet Gynecol 83:750–754PubMedGoogle Scholar
  131. Matorras R, Diez J, Pereira JG (1990) True knots in the umbilical cord: clinical findings and fetal consequences. J Obstet Gynaecol 10:383–386CrossRefGoogle Scholar
  132. Mayhew TM, Burton GJ (1988) Methodological problems in placental morphometry: apologia for the use of stereology based on sound sampling practice. Placenta 9:565–581PubMedCrossRefGoogle Scholar
  133. McCowan LM, Becroft DM (1994) Beckwith-Wiedmann syndrome, placental abnormalities, and gestational proteinuric hypertension. Obstet Gynecol 83:813–817PubMedGoogle Scholar
  134. McDermott M, Gillan JE (1995) Trophoblast basement membrane haemosiderosis in the placental lesion of fetal artery thrombosis: a marker for disturbance of mater-nofetal transfer. Placenta 16:171–178PubMedCrossRefGoogle Scholar
  135. Meekins JW, Pijnenborg R, Hanssens M, McFadyen IR, van Assche A (1994) A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. Br J Obstet Gynaecol 101:669–674PubMedCrossRefGoogle Scholar
  136. Miller PW, Coen RW, Benirschke K (1985) Dating the time interval from meconium passage to birth. Obstet Gynecol 66:459–462PubMedGoogle Scholar
  137. Mills JL, Harley EE, Moessinger AC (1983) Standards for measuring umbilical cord length. Placenta 4:423–426PubMedCrossRefGoogle Scholar
  138. Minkoff H, Nanda D, Menez R, Fikrig S (1987) Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS-related complex. Obstet Gynecol 69:285–287PubMedGoogle Scholar
  139. Mochizuki M, Maruo T, Masuko K, Ohtsu T (1984) Effects of smoking on fetoplacental-maternal system during pregnancy. Am J Obstet Gynecol 149:413–420PubMedGoogle Scholar
  140. Moessinger AC, Blanc WA, Marone PA, Polsen DC (1982) Umbilical cord length as an indicator of fetal activity: experimental study and clinical implications. Pediatr Res 16:109–112PubMedCrossRefGoogle Scholar
  141. Mooney EE, Al Shunnar A, O’Regan M, Gillan JE (1994) Chorionic villous haemorrhage is associated with retropla-cental haemorrhage. Br J Obstet Gynaecol 101:965–969PubMedCrossRefGoogle Scholar
  142. Morey AL, Keeling JW, Porter HJ, Fleming KA (1992) Clinical and histopathological features of parvovirus B19 infection in the human fetus. Br J Obstet Gynaecol 99:566–574PubMedCrossRefGoogle Scholar
  143. Mortimer G, MacDonald DJ, Smeeth A (1985) A pilot study of the frequency and significance of placental villitis. Br J Obstet Gynaecol 92:629–633PubMedCrossRefGoogle Scholar
  144. Mostofi-Zadeh M, Driscoll SG, Biano SA, Kundsin RB (1984) Placental evidence of cytomegalovirus infection of the fetus and neonate. Arch Pathol Lab Med 108:403–406Google Scholar
  145. Naeye RL (1977) Placental abnormalities in victims of sudden infant death syndrome. Biol Neonate 32:189–192PubMedCrossRefGoogle Scholar
  146. Naeye RL (1980) Placental disorders and smoking. Obstet Gynecol 55:701–704PubMedGoogle Scholar
  147. Naeye RL (1985) Umbilical cord length: clinical significance. J Pediatr 107:278–281PubMedCrossRefGoogle Scholar
  148. Naeye RL (1990) The clinical significance of absent subchorionic fibrin in the placenta. Am J Clin Pathol 94:196–198PubMedGoogle Scholar
  149. Naeye RL (1992) Disorders of the placenta, fetus, and neonate: Diagnosis and clinical significance. Mosby, St LouisGoogle Scholar
  150. O’Herlihy C, O’Driscoll K (1987) Diseases associated with abnormal placenta. In: Lavery JP ed. The Human Placenta. Aspen Publishers, Rockville, 237–256Google Scholar
  151. Osak R, Webster KM, Bocking AD et al. (1997) Nuchal cord evident at birth impacts on fetal size relative to that of the placenta. Early Hum Dev 49:193–202PubMedCrossRefGoogle Scholar
  152. Pearlstone M, Baxi L (1993) Subchorionic hematoma: a review. Obstet Gynecol Surv 48:65–68PubMedCrossRefGoogle Scholar
  153. Perry I J, Beevers DG, Whincup PH, Bareford D (1995) Predictors of ratio of placental weight to fetal weight in multiethnic community. Br Med J 310:436–439CrossRefGoogle Scholar
  154. Pijnenborg R, Bland JM, Robertson WB, Dixon G, Brosens I (1981) The pattern of interstitial trophoblast invasion of the myometrium in early human pregnancy. Placenta 2:303–316PubMedCrossRefGoogle Scholar
  155. Pridmore BR, Khong TY, Wells WA (1994) Ultrasound placental cysts associated with massive placental stem villous hydrops, diploid DNA content and exomphalos. Am J Perinatol 11:14–18PubMedCrossRefGoogle Scholar
  156. Quek SP, Tan KL (1972) Vasa praevia. Aust NZ J Obstet Gynaecol 12:20620–9CrossRefGoogle Scholar
  157. Qureshi F, Jacques SM (1994) Marked segmental thinning of the umbilical cord vessels. Arch Pathol Lab Med 118: 826–830PubMedGoogle Scholar
  158. Raymond EG, Mills JL (1993) Placental abruption. Maternal risk factors and associated fetal conditions. Acta Obstet Gynecol Scand 72:633–639PubMedCrossRefGoogle Scholar
  159. Rayne SC, Kraus FT (1993) Placental thrombi and other vascular lesions: classification, morphology, and clinical correlations. Pathol Res Pract 189:2–17PubMedCrossRefGoogle Scholar
  160. Redline RW, Pappin A (1995) Fetal thrombotic vasculopathy: the clinical significance of extensive avascular villi. Hum Pathol 26:80–85PubMedCrossRefGoogle Scholar
  161. Redline RW, Patterson P (1993) Villitis of unknown etiology is associated with major infiltration of fetal tissue by maternal inflammatory cells. Am J Pathol 143:332–336Google Scholar
  162. Redline RW, Patterson P (1995) Pre-eclampsia is associated with an excess of proliferative immature intermediate trophoblast. Hum Pathol 26:594–600PubMedCrossRefGoogle Scholar
  163. Robinson LK, Jones KL, Benirschke K (1983) The nature of structural defects associated with velamentous and marginal insertion of the umbilical cord. Am J Obstet Gynecol 146:191–193PubMedGoogle Scholar
  164. Romero R, Quintero R, Oyarzun E et al. (1988) Intraamniotic infection and the onset of labor in preterm premature rupture of membranes. Am J Obstet Gynecol 159:661–666PubMedGoogle Scholar
  165. Ross JA, Jurkovic D, Zosmer N et al. (1997) Umbilical cord cysts in early pregnancy. Obstet Gynecol 89:442–445PubMedCrossRefGoogle Scholar
  166. Russell P (1980) Inflammatory lesions of the human placenta. III The histopathology of villitis of unknown aetiology. Placenta 1:227–244PubMedCrossRefGoogle Scholar
  167. Salafia CM, Mangam HE, Weigl CA, Foye GJ, Silberman L (1989) Abnormal fetal heart rate patterns and placental inflammation. Am J Obstet Gynecol 160:140–147PubMedGoogle Scholar
  168. Sailer DN, Keene CL, Sun C-CJ, Schwartz S (1990) The association of single umbilical artery with cytogenetically abnormal pregnancies. Am J Obstet Gynecol 163:922–925Google Scholar
  169. Sander CH, Kinnane L, Stevens NG, Echt R (1986) Haemorrhagic endovasculitis of the placenta: a review with clinical correlation. Placenta 7:551–574PubMedCrossRefGoogle Scholar
  170. Sander CM, Gilliland D, Flynn MA, Swart-Hills LA (1997) Risk factors for recurrence of hemorrhagic endovasculitis of the placenta. Obstet Gynecol 89:569–576PubMedCrossRefGoogle Scholar
  171. Scardo JA, Ellings JM, Newman RB (1995) Prospective determination of chorionicity, amnionicity, and zygosity in twin gestations. Am J Obstet Gynecol 173:1376–1380PubMedCrossRefGoogle Scholar
  172. Schwartz DA, Larsen DA, Beck-Sague C, Fears M, Rice RJ. (1995) Pathology of the umbilical cord in congenital syphilis: analysis of 25 cases. Hum Pathol 26:781–784CrossRefGoogle Scholar
  173. Sepulveda W, Gutierrez J, Sanchez J, Be C, Schrapp C (1999) Pseudocyst of the umbilical cord: prenatal sonographic appearance and clinical significance. Obstet Gynecol 93: 377–381PubMedCrossRefGoogle Scholar
  174. Shen-Schwarz S, Ruchelli E, Brown D (1989) Villous oedema of the placenta: a clinicopathological study. Placenta 10:297–307PubMedCrossRefGoogle Scholar
  175. Siddiqi TA, Bendon R, Schultz DM, Miodovnik M (1992) Umbilical artery aneurysm: prenatal diagnosis and management. Obstet Gynecol 80:530–533PubMedGoogle Scholar
  176. Sondergaard G (1994) Hemangioma of the umbilical cord. Acta Obstet Gynecol 73:434–436CrossRefGoogle Scholar
  177. Spellacy WN, Gravem H, Fisch RO (1966) The umbilical cord complications of true knots, nuchal coils, and cords around the body. Am J Obstet Gynecol 94:1136–1142PubMedGoogle Scholar
  178. Strong SJ, Corney G (1967) The placenta in twin pregnancy. Pergamon, OxfordGoogle Scholar
  179. Strong TH, Elliot JP, Radin TG (1993) Non-coiled umbilical blood vessels: a new marker for the fetus at risk. Obstet Gynecol 81:409–411PubMedGoogle Scholar
  180. Trask C, Lage JM, Roberts DJ (1994) A second case of “chorangiocarcinoma” presenting in a term asymptomatic twin pregnancy: choriocarcinoma in situ with associated villous vascular proliferation. Int J Gynecol Pathol 13:87–91PubMedCrossRefGoogle Scholar
  181. Trudinger BJ, Giles WB, Cook CM, Bombardieri J, Collins L (1985) Fetal umbilical artery flow velocity waveforms and placental resistance: clinical significance. Br J Obstet Gynaecol 92:23–30PubMedGoogle Scholar
  182. Tuchmann-Duplessis H, David G, Haezel P (1971) Illustrated human embryology, vol 1. Springer, New YorkGoogle Scholar
  183. Van der Veen F, Fox H (1983) The human placenta in idiopathic intrauterine growth retardation: a light and electron microscopic study. Placenta 4:65–78PubMedCrossRefGoogle Scholar
  184. Wenstrom KD, Tessen JA, Zlatnik FJ, Sipes SL (1992) Frequency, distribution, and theoretical mechanisms of hematologic and weight discordance in monochorionic twins. Obstet Gynecol 80:257–261PubMedGoogle Scholar
  185. Wigglesworth J (1964) Morphological variations in the insufficient placenta. J Obstet Gynaecol Br Commonw 71:871–884PubMedCrossRefGoogle Scholar
  186. Wilkins-Haug L, Roberts DJ, Morton CC (1995) Confined placental mosaicism and intrauterine growth retardation: a case-control analysis of placentae at delivery. Am J Obstet Gynecol 172:44–50PubMedCrossRefGoogle Scholar
  187. Wolstenholme J, Rooney DE, Davison EV (1994) Confined placental mosaicism, IUGR, and adverse pregnancy outcome: a collaborative retrospective U.K. collaborative survey. Prenat Diagn 14:345–361PubMedCrossRefGoogle Scholar
  188. Zaaijman JduT, Wilkinson AR, Keeling JW, Mitchell RG, Turnbull AC (1982) Spontaneous premature rupture of the membranes: bacteriology, histology and neonatal outcome. J Obstet Gynaecol 2:155–160CrossRefGoogle Scholar
  189. Zhang J, Kraus FT, Aquino TI (1985) Chorioamnionitis: a comparative histologic, bacteriologic, and clinical study. Int J Gynecol Pathol 4:1–10PubMedCrossRefGoogle Scholar

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© Springer-Verlag London 2001

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  • T. Yee Khong

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