Table 3 Maternal vascular malperfusion (MVM): summary.

From: Four major patterns of placental injury: a stepwise guide for understanding and implementing the 2016 Amsterdam consensus

Defining features

   Accelerated villous maturation or distal villous hypoplasia

Associated findings

   Decreased placental weight/ increased fetoplacental weight ratio for GA

   Villous infarcts/ Infarction-hematomas

   Decidual arteriopathy: mural hypertrophy, fibrinoid necrosis, acute atherosis

   Thin umbilical cord (<8 mm maximum diameter)

   Superficial implantation site: muscularized basal plate arteries, basal plate trophoblast giant cells

High grade (provisional)

   MVM with placental weight < 3rd percentile for GA, multiple infarcts or distal villous hypoplasia

Differential diagnosis/pitfalls

   Focally increased syncytial knots (alone)

   Villous dysmaturity

   Dysmorphic villi

   Perivillous fibrin plaque (localized perivillous fibrin deposition)

   Massive perivillous fibrin deposition (“maternal floor infarction”)

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