title: Successful pregnancy following treatment of recurrent chronic histiocytic intervillositis.
abstract: Chronic histiocytic intervillositis (CHI) is a rare placental lesion associated with adverse obstetric outcomes and high recurrence rate. We report a case of six consecutive pregnancies in one woman, where CHI was detected following an intrauterine death in the fifth pregnancy, after being missed in four earlier losses. The successful sixth pregnancy was treated with a combination of immunosuppressive and antithrombotic agents. While low-molecular-weight heparin (LMWH) and aspirin had been shown to improve pregnancy outcome in recurrent pregnancy loss, there was limited evidence of improved outcome in CHI. It has been suggested that CHI may result from a maternal immunological process and there have been a few reports of the use of corticosteroids because of this possibility, though without convincing evidence of efficacy. We too tried a corticosteroid, in combination with LMWH and aspirin. Comparative histopathological analysis of the placentae supported post-treatment effectiveness of our intervention strategy.
authors.affiliation: Department of Women's Health, Dunedin Public Hospital, Dunedin, New Zealand.|Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
authors.forename: Leehe
authors.identifier: http://orcid.org/0000-0002-9832-8076
authors.initials: L
authors.lastname: Vardi
authors.affiliation: Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
authors.forename: Helen
authors.identifier: http://orcid.org/0000-0002-8240-082X
authors.initials: H
authors.lastname: Paterson
authors.affiliation: Department of Pathology, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand.
authors.forename: Noelyn Anne
authors.initials: NA
authors.lastname: Hung
mesh_terms: D000026:Abortion, Habitual / Q000517:prevention & control; D000328:Adult; D002821:Chorioamnionitis / Q000188:drug therapy*; D002824:Chorionic Villi; D002908:Chronic Disease; D005260:Female; D015614:Histiocytosis / Q000188:drug therapy*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012008:Recurrence