Placental infarction refers to a localized area of ischemic villous necrosis. It is a significant cause of placental insufficiency.
A localized infarction can occur in up to ~25% of all placental pathologies and approximately 5-20% of all gestations (on average 12.5%) 6.
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, unless hemorrhagic in nature 6. 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.
Growth restriction is often present if 15% or more of placental tissue is involved.
An infarction in the first or second trimester within the center of the placenta or with extensive involvement of the placenta (more than 50%) is much more concerning and may lead to fetal death.
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- 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
- 5. Sabine Dekan, Nina Linduska. Normal and Pathological Placental Development: MRI and Pathology. (2020) doi:10.1007/174_2010_61
- 6. Wolfgang Dähnert. Radiology Review Manual. (2020) ISBN: 9781609139438