MASSIVE CHRONIC INTERVILLOSITIS ASSOCIATED WITH RECURRENT ABORTIONS

Massive chronic intervillositis (MCI) is an unusual placental lesion a ssociated with poor fetal growth and adverse pregnancy outcome; it has not previously been associated with spontaneous abortion or recurrent pregnancy loss. This article reports a patient who had 10 spontaneous abortions with repetitious massive chronic intervillositis documented in four of five gestations spanning all three trimesters. Characteris tic placental histology included massive infiltration of the maternal intervillous space by chronic inflammatory cells and fibrin, without a ssociated chronic villitis; the cellular infiltrate was composed predo minantly of LCA and CD68 immunoreactive cells with scattered CD45RO po sitivity, consistent with a monocyte/macrophage population with occasi onal T lymphocytes. Elevated maternal serum alphafetoprotein was docum ented in two pregnancies, These findings support the concept that this unusual placental lesion may have an immunologic basis, and suggest t hat MCI may be a histopathologically recognizable cause of recurrent s pontaneous abortion. Copyright (C) 1995 by W.B. Saunders Company