Amy Heerema-McKenney

Unlike every other human organ, placentas vary broadly in size, shape and umbilical cord morphology. The microscopic appearance also varies as it changes throughout gestation and differs between individuals. This variation can make placental pathology daunting. However, understanding the fundamentals of how the maternal vessels are remodeled for pregnancy and how maternal blood circulates through the placental lobules brings cohesion to our understanding. The changes of maternal vascular malperfusion, fetal vascular malperfusion, hemorrhage, hematomas and fibrin deposition make much more sense in this context. We will review the scholarship of how the maternal and fetal placental circulation interfaces, reframe diagnostic criteria in this context and review the clinical significance of these changes as they relate to fetal and maternal future well-being