Placental infarction refers to a localised area of ischaemic villous necrosis. It is a significant cause of placental insufficiency.
A localized infarction can occurs in up to ~12.5% (range 5-20%) of all gestations.
It usually results from an interrupted maternal blood supply
Placental infarcts are more common at the periphery of the placenta.
- post-term pregnancies
- maternal hypertension
- retroplacental hemorrhage
- other maternal medical conditions
- anticardiolipin antibodies
- chronic nephritis
- systemic lupus erythematosus (SLE)
- diabetic microangiopathy
Most placental infarcts are difficult to diagnose on ultrasound. They may on occasion be seen as a hypoechoic region with thick hyperechoic rim and/or as a well circumscribed mixed/hyperechoic pattern mass.
Treatment and prognosis
Those that occur at the placental margins are usually of no clinical significance at this location. An infarction in the first or second trimester within the centre of the placenta or with extensive involvement of the placenta (more than 50%) is much more concerning.
- 1. Barclay D, Evans K, Fox R. Ultrasound-diagnosed placental infarction in a woman with recurrent fetal growth restriction. J Obstet Gynaecol. 2005;25 (2): 200-1. doi:10.1080/01443610500051825 - Pubmed citation
- 2. Elsayes KM, Trout AT, Friedkin AM et-al. Imaging of the placenta: a multimodality pictorial review. Radiographics. 29 (5): 1371-91. doi:10.1148/rg.295085242 - Pubmed citation
- 3. Harris RD, Simpson WA, Pet LR et-al. Placental hypoechoic-anechoic areas and infarction: sonographic-pathologic correlation. Radiology. 1990;176 (1): 75-80. Radiology (abstract) - Pubmed citation
- 4. Alkazaleh F, Viero S, Simchen M et-al. Ultrasound diagnosis of severe thrombotic placental damage in the second trimester: an observational study. Ultrasound Obstet Gynecol. 2004;23 (5): 472-6. doi:10.1002/uog.1044 - Pubmed citation