Which placental vascular change, resulting from failed transformation of spiral arteries, is considered characteristic of the uteroplacental bed in pre-eclampsia?

• A Diffuse chorangiosis of terminal villi
• B Hypertrophic arteriolar medial hyperplasia confined to decidua vera
• C Granulomatous vasculitis with giant cell infiltration
• D Acute atherosis with fibrinoid necrosis of spiral arterioles ✓

Explanation

In pre-eclampsia there is defective endovascular invasion by extravillous trophoblast, leaving spiral arteries muscularized. The vessel walls show fibrinoid necrosis with lipid-laden macrophages in the intima, termed acute atherosis, which reduces placental perfusion and contributes to fetal growth restriction. Chorangiosis reflects chronic hypoxia but is nonspecific, while granulomatous vasculitis suggests infection such as syphilis or tuberculosis rather than a hypertensive disorder of pregnancy.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.