Placental pathology in congenital rubella

Placental and Fetal Pathology in Intrauterine Viral Infections

“…An infection during the first 8 weeks of gestation results in multiple embryonal malformations. Villous changes were first described by Driscoll [13] and confirmed by others [14,15]. Histologic changes consistent with rubella infections are hemorrhagic endovasculitis ( fig.…”

Histologic correlates of viral and bacterial infection of the placenta associated with severe morbidity and mortality in the newborn

“…Although the placenta may show severe villitis in cases of neonatal infection, it has been well documented that infection of the villi may be associated with minor, nonspecific histologic changes in cases of severe neonatal morbidity. [1][2][3][4][5][6][13][14][15][16][17][18] For example, the histologic changes in the placenta in cases of infection by rubella, enterovirus, HIV-1, and group B streptococcus may be minor when there is marked neonatal morbidity. [1][2][3][4][5][6][13][14][15][16][17][18] Although this may reflect sampling, it was noted in this study that the infectious agent was usually present in Ն10% of villi and in each of the placental blocks examined.…”

“…However, in many cases, there is poor correlation between the pathologic findings in the placenta and neonatal outcome. [1][2][3][4][5][6] This lack of correlation probably has multiple explanations, including relatively reduced immunologic activity in the placenta and the importance of cytokine-modulated vascular constriction in fetal vessels that can be strongly and directly influenced by a variety of viral and bacterial products. 7 Thus, although certain histologic changes such as lymphoplasmacytic and granulomatous villitis may suggest a certain infectious etiology (syphilis), in most cases the histologic findings are considered nonspecific.…”

“…7 Thus, although certain histologic changes such as lymphoplasmacytic and granulomatous villitis may suggest a certain infectious etiology (syphilis), in most cases the histologic findings are considered nonspecific. [1][2][3][4][5][6] This statement applies even in cases such as rubella, coxsackie virus, and group B streptococcal infection of the placenta, in which there is unequivocal and serious morbidity in the child. [1][2][3][4][5][6] Neonatal morbidity, especially as it relates to encephalopathy, is a serious issue with strong medicolegal implications.…”

“…[1][2][3][4][5][6] This statement applies even in cases such as rubella, coxsackie virus, and group B streptococcal infection of the placenta, in which there is unequivocal and serious morbidity in the child. [1][2][3][4][5][6] Neonatal morbidity, especially as it relates to encephalopathy, is a serious issue with strong medicolegal implications. A report issued on January 31, 2003 by the American College of Obstetricians and Gynecologists and the American Academy of Pediatricians concluded, "an underlying event before labor was the primary factor for the adverse outcome associated with newborn encephalopathy and cerebral palsy in 70% of cases."…”