Chronic intervillositis of unknown etiology (CIUE): relation between placental lesions and perinatal outcome

Abstract

Objectives: To evaluate perinatal outcome of pregnancies complicated by chronic intervillositis of unknown etiology (CIUE) and to study the relation between extent of such placental histological lesions and clinical expression.

Study design: Descriptive and retrospective study including all cases of CIUE diagnosed between 2000 and 2006 in the university hospital of Toulouse (France). Perinatal outcome was evaluated according to the extent of placental lesions assessed by semi-quantitative graduation.

Results: Twenty pregnancies complicated by CIUE were included (14 patients). Three pregnancies were prematurely interrupted spontaneously during the first trimester. Perinatal outcome of the remaining 17 pregnancies beyond 22 WG was: 4 intrauterine fetal deaths, 3 terminations of pregnancy for early and severe intrauterine growth restriction (IUGR), and 10 live births (58.8%). All fetal deaths, 82.3% of pregnancies beyond 22 WG and 70% of live births were growth restricted. Severe intervillositis with massive fibrinoid deposition was associated with a severe perinatal prognosis whereas focal forms had a best evolution. The rate of recurrence was 100% in the reported cases.

Conclusion: CIUE have a poor perinatal outcome and a high rate of recurrence. There is a relation between clinical expression and histological lesions.