Do placental lesions reflect thrombophilia state in women with adverse pregnancy outcome?

We examined the relationship between placental histology and thrombophilia status in women who were admitted with severe pre-eclampsia/eclampsia, plac ental abruption, intrauterine growth restriction or unexplained stillbirth. All women had thrombophilia screen at least 10 weeks after delivery (antit hrombin III, protein C, protein S, activated protein C resistance, anticard iolipin antibodies, lupus anticoagulant, fasting plasma homocysteine and sp ecific mutations to methylenetetrahydrofolate reductase C677T, G20210A prot hrombin gene and factor V Leiden. Placental histology reports were examined to identify the frequency of thrombotic lesions in the placenta including fetal stem vessel thrombosis, fetal thrombotic vasculopathy, placental infa rction, perivillous fibrin deposition, intervillous thrombosis and placenta l floor infarction, During a 17 month period, a cohort of 79 women met the study criteria. Thirty (70%) out of 43 women with abnormal thrombophilia sc reen had abnormal placental histology, Twenty-eight (78%) out of 36 women w ith negative thrombophilia screen had abnormal placentae, No specific histo logical pattern could be identified when thrombophilia positive and thrombo philia negative groups were compared. We propose that there is a poor corre lation between thrombophilia status and pathological changes of the placent a in women with severe pregnancy complications.