Chronic histiocytic intervillositis- a rare placental cause of poor obstetric outcome: a clinicopathological study and literature review

Ramya T, Chaitra V, Umamaheswari G


Chronic histiocytic intervillositis (CHIV) of the placenta is a rare and poorly understood entity which may occur in all trimesters of pregnancy. Till date about 60 cases of CHIV has been reported, with high rate of recurrences in subsequent pregnancies. There is increased risk of perinatal mortality and fetal growth restriction in this group, hence diagnosing CHIV becomes important to predict the outcome of subsequent pregnancies and also to understand the pathogenesis, thus treatment choices. Here in, we present a case of CHIV in a primigravida with second trimester pregnancy loss.


Chronic histiocytic intervillositis, Rare recurrent placental pathology, Perinatal mortality, Fetal growth restriction

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Labarrere C, Mullen E. Fibrinoid and tropholastic necrosis with massive chronic intervillositis: an extreme variant of villitis of unknown etiology. Am J Reprod Immunol Microbiol. 1987;15:85-91.

Jacques SM, Qureshi F. Chronic intervillositis of placenta. Arch Pathol Lab Med. 1993;117:1032-5.

Doss BJ, Greene MF, Hill J, Heffner LJ, Bieber FR, Genest DR. Massive chronic intervillositis associated with recurrent abortions. Hum Pathol. 1995;26:1245-51.

Boyd TK, Redline RW. Chronic histiocytic intervillositis: a placental lesion associated with recurrent reproductive loss. Hum Pathol. 2000;31:1389-96.

Parant O, Capdet J, Kessler S, Aziza J, Berrebi A. Chronic intervillositis of unknown etiology (CIUE): relation between placental lesions and perinatal outcome. Eur J Obstet Gynaecol Reprod Biol. 2009;143:9-13.

Rota C, Carles D, Schaeffer V, Guyon F, Saura R, Horovitz J. Perinatal prognosis of pregnancies complicated by placental chronic intervillitis. J Gynaecol Obstet Biol Reprod (Paris). 2006;35:711-9.

Redline RW. Placental inflammation. Semin Neonatal. 2004;9:265-74.

Kraus F. Placental pathology, inflammation and infection. In: American Registry of Pathology, eds. Atlas of Non Tumour Pathology. Washington: AFIP Collection; 2004: 36, 101-107, 135-140.

Nessman CLJ, Jauniaux E. Maternal immune reaction. In: Nessman CLJ, Jauniaux E, eds. Atlas de pathologie placentaire. US: Elsevier-Masson; 2001: 1-156.

Traeder J, Jonigk D, Feist H, Bröcker V, Länger F, Kreipe H, et al. Pathological characteristics of rare chronic histiocytic intervillositis of the placenta. Placenta. 2010;31:1116-9.

Dollmann A, Schmitz-Moormann P. Recurrent placental insufficiency due to villous placentitis with extreme growth retardation (birth weights 1030 g. and 1000 g. at term). Geburstshilfe Frauenheilkd. 1972;32:795-801.

Contro E, DeSouza R, Bhide A. Chronic intervillositis of placenta: a systematic review. Placenta. 2010;31:1106-10.

Marchaudon V, Devisme L, Petit S, Ansart-Franquet H, Vaast P, Subtil D. Chronic histiocytic intervillositis of unknown etiology: clinical features in a consecutive series of 69 cases. Placenta. 2011;32:140-5.

Salafia CM, Cowchock FS. Placental pathology and antiphospholipid antibodies: a descriptive study. Am J Perinatol. 1997;14:435-41.

Debra S. Heller. CD68 immunostaining in the evaluation of chronic histiocytic intervillositis. Arch Pathol Lab Med. 2012 Jun;136(6):657-9.