Enterovirus Placentitis is an Underrecognized Cause of Placental Pathology.

Cohort studyThe American journal of surgical pathology· Jun 2025

Enterovirus Placentitis is an Underrecognized Cause of Placental Pathology.

Andrew P Norgan, Elizabeth Ann L Enninga, Bohdana Fedyshyn … Elisheva D Shanes

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Breast & Gynecologic PathologyCohort studyDiagnosisQ1IF 4.3

Enterovirus DNA found in 18% of placentas with massive perivillous fibrin deposition.

Enterovirus Placentitis is an Underrecognized Cause of Placental Pathology.

Andrew P Norgan … Elisheva D Shanes

The American journal of surgical pathology · Jun 2025 · Q1 in Pathology

Background

The placenta is susceptible to infection by a number of viral pathogens, including severe acute respiratory syndrome coronavirus 2, which is associated with poor fetal outcomes.

Methods

We evaluated 46 placentas collected between 2011 and 2022 with a diagnosis of massive perivillous fibrin deposition (n = 41) or chronic histiocytic intervillositis (CHI; n = 4).

n = 41

18%

Results

18%

enterovirus infection is an underrecognized cause of this placental pattern

n = 41

More results

The histologic pattern of injury, termed severe acute respiratory syndrome coronavirus 2 placentitis, is characterized by a triad of increased perivillous fibrin deposition, intervillous histiocytes, and trophoblast necrosis.

Seven of these positive cases were from massive perivillous fibrin deposition, and 1 was associated with a CHI diagnosis.

More results

Enterovirus A species (n = 7) were commonly identified, whereas one case had Enterovirus B.

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Conclusion

Further study to evaluate the recurrence risk of Enterovirus placentitis in comparison to massive perivillous fibrin deposition may help inform future fertility planning in patients with these diagnoses.

Enterovirus Placentitis is an Underrecognized Cause of Placental Pathology.

Enterovirus Placentitis is an Underrecognized Cause of Placental Pathology.

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