Placental infarction

Last revised by Jeremy Jones on 20 Sep 2021

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.

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.

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.

Intrauterine growth retardation, fetal death, and recurrent abortion have been associated with large (>10% of parenchyma) or early-onset infarctions.

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