Fetal thrombotic vasculopathy and perinatal thrombosis: should all placentas be examined?

Objective  Numerous fetal placenta vascular lesions seem to be a predisposing condition for some types of perinatal disease. Placental disease and newborn thromboses might be both manifestations of the same underlying disorder. Objective of this study is to describe pathological lesions of the placenta in newborns with perinatal thrombosis. Study Design  We present retrospective data review and analysis regarding neonates admitted at our neonatal intensive care unit and diagnosed with an episode of thromboembolic events (TE) in the period from 2009 to 2013; among them we report three cases of perinatal thrombosis in newborns whose placentas demonstrated fetal thrombotic vasculopathy (FTV). Results  In all the three cases a prothrombotic maternal condition was found, and in one patient a maternal infection with chorioamnionitis; the histological examination of placenta, required soon after birth for maternal pathological conditions, was important in confirming and explaining the clinical diagnosis of neonatal thrombosis and for the management of future pregnancies. Conclusion  It is proposed that placenta of newborns with TE in first days of life should always be examined, for its association with FTV and thus the storage of placentas for a week after birth should be routinely implemented.