circulation in intra-uterine growth restriction.
Histological examination of placental abruption shows changes in decidua basalis, chorionic plate and intervillous
When severe and sustained, hypotension can impair uterine and intervillous
blood flow, which can ultimately result in foetal acidosis and neonatal depression.
The cotyledons that are visible on the maternal surface of the placenta show a good correspondence to the position of the villous trees derived from the chorionic plate in the intervillous
space or blood chamber (Huppertz; Prieto Gomez et al., 2008; Carlson).
(A) Head ultrasound of a 23-week fetus with CTX showing lateral ventriculomegaly (bidirectional arrow), as well as periventricular and scattered parenchymal brain echogenic foci representing calcification (arrows); (B) axial abdominal ultrasound of the same fetus demonstrating hepatomegaly and intrahepatic hyperechogenicities (arrows); (C) axial abdominal ultrasound of a 25-week fetus showing multiple echogenic foci on the peritoneal surface representing areas of calcification; (D) an enlarged placenta containing hypoechogenic areas (asterisk) representing placental infarct and intervillous
Pre-eclampsia is a multisystem disease, causing impaired intervillous
blood flow leading to a state of oxidative stress that activates vascular endothelial cells, leading to wide spread effects of pre-eclampsia2.
This facilitates adhesion to the gut mucosal layer and penetration into the intervillous
space leading to a higher diffusion rate of the drug [24, 26, 49].
The histological examination of the placenta highlighted intense vascular congestion of villi and hematic infiltrates as for intervillous
The placenta produces a large amount of PGI2 that protects against thrombosis during low pressure in the intervillous
In a normal pregnancy, there is a considerable increase in uterine blood flow in order to ensure adequate supplementation for the intervillous
space and, by extension, adequate fetal development.
In the literature, 36 cases of invasion of chorionic villi (fetal space) have been reported, but only 3 cases have been reported with invasion of the intervillous
space with a risk of maternal dissemination of the tumor [10, 11] (Table 2).
 These changes could lead to a reduction in blood flow to the intervillous
spaces, and alteration in the structure of the placental barrier, thereby impacting negatively on the transplacental transfer of molecules.