title: Placental infarction and thrombophilia.
abstract: OBJECTIVE
  To estimate the relative importance of positive maternal thrombophilia testing compared with additional pathological evidence of abnormal placentation with placental infarction.
  
  
  METHODS
  We performed a retrospective cohort study over a 10-year period in 180 singleton high-risk pregnancies (delivery at 22-34 6/7 weeks of gestation) that had histologic evidence of placental infarction. The rate of positive maternal tests for antiphospholipid syndrome, factor V Leiden, and prothrombin gene mutation were compared with the rate of detection of one or more gross or histological features of abnormal placentation (impaired placental development or differentiation, maternal vascular underperfusion, fetal vascular underperfusion, chronic inflammation, or intervillous thrombosis).
  
  
  RESULTS
  Only 14 of 108 (13.0%) of placentas with documented infarction were associated with a positive maternal thrombophilia result. In contrast, 67 of 108 (62.3%) placentas showed features of abnormal placental development or differentiation and 85 of 108 (78.7%) had evidence of noninfarct-related maternal vascular underperfusion (P<.001). Only four of 108 (3.7%) infarcted placentas had no other pathologic lesions.
  
  
  CONCLUSIONS
  Our data indicate that gross and histologic features of abnormal placentation associate strongly with placental infarction in comparison with maternal thrombophilia tests.
  
  
  METHODS
  II.
authors.affiliation: From the University of Toronto, Faculty of Medicine, Toronto, Canada; the Departments of Obstetrics and Gynaecology and Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada; and the Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Franco
authors.forename: Melissa
authors.initials: M
authors.lastname: Walker
authors.forename: Julie
authors.initials: J
authors.lastname: Robertson
authors.forename: Brendan
authors.initials: B
authors.lastname: Fitzgerald
authors.forename: Sarah
authors.initials: S
authors.lastname: Keating
authors.forename: Anne
authors.initials: A
authors.lastname: McLeod
authors.forename: John C P
authors.initials: JCP
authors.lastname: Kingdom
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007238:Infarction / Q000453:epidemiology* / Q000473:pathology; D008423:Maternal Age; D010920:Placenta / Q000098:blood supply*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D019851:Thrombophilia / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult