Chronic histiocytic intervillositis as a cause of pregnancy loss and antenatal fetal death
Larina E.B., Shestakova L.A., Kurtser M.A.
Rationale. Recurrent pregnancy loss, fetal growth restriction, and antenatal fetal death present a group of complex, multifactorial conditions with significant economic and social implications. Chronic histiocytic intervillositis is a significant though little-known cause of perinatal loss.
Case report. A clinical case is presented of a 35-year-old patient with recurrent pregnancy loss, comprising five first-trimester missed miscarriages and two cases of intrauterine fetal death at 29 and 31 weeks of gestation. Histological and immunohistochemical examination of the placentas revealed chronic histiocytic intervillositis. The use of combination therapy resulted in a successful pregnancy outcome.
Conclusion. The use of immunomodulatory therapy is advisable in cases of recurrent pregnancy loss caused by chronic histiocytic intervillositis.
Authors’ contributions. Larina E.B. – patient’s observation, manuscript drafting; Shestakova L.A. – pathomorphological examination; Kurtser M.A. – manuscript editing.
Conflicts of interest. The authors declare no possible conflict of interests.
Funding. The research had no sponsorship.
Generative Artificial Intelligence. No generative AI technologies were used for the creation of this article.
Patient Consent for Publication. The patient signed an informed consent for the publication of her data and associated images.
For citation: Larina E.B., Shestakova L.A., Kurtser M.A. Chronic histiocytic intervillositis as
a cause of pregnancy loss and antenatal fetal death.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (10): 146-150 (in Russian)
https://dx.doi.org/10.18565/aig.2026.316
Keywords
chronic histiocytic intervillositis
fetal growth restriction
antenatal fetal death
recurrent pregnancy loss
References
- Михалев С.А., Курцер М.А., Радзинский В.Е., Оразов М.Р., Печникова В.В., Кудрявцев Г.Ю., Кудрявцева Я.Ю., Михалёва Л.М. Патология плаценты при преждевременных родах: систематизация морфологических повреждений. Вопросы гинекологии, акушерства и перинатологии. 2026; 25(2): 32-42. https://dx.doi.org/10.20953/1726-1678-2026-2-32-42 [Mikhalev S.A., Kurtser M.A., Radzinsky V.E., Orazov M.R., Pechnikova V.V., Kudryavtsev G.Yu., Kudryavtseva Ya.Yu., Mikhaleva L.M. Placental pathology in preterm birth: systematization of morphological lesions. Gynecology, Obstetrics and Perinatology. 2026; 25(2): 32-42 (in Russian). https://dx.doi.org/10.20953/1726-1678-2026-2-32-42].
- Щеголев А.И., Серов В.Н. Клиническая значимость поражений плаценты. Акушерство и гинекология. 2019; 3: 54-62. https://dx.doi.org/10.18565/aig.2019.3.54-62 [Shchegolev A.I., Serov V.N. Clinical significance of placental lesions. Obstetrics and Gynecology. 2019; (3): 54-62. https://dx.doi.org/10.18565/aig.2019.3.54-62].
- Низяева Н.В. Гистологические критерии воспалительных изменений ворсинчатого дерева плаценты. Международный журнал прикладных и фундаментальных исследований. 2018; 2: 202-7. [Nizyaeva N.V. Histological criteria for inflammatory changes in the villous tree of the placenta. International Journal of Applied and Fundamental Research. 2018; 2: 202-7 (in Russian)].
- Moar L., Simela Ch., Nanda S., Marnerides A., Al-Adnani M., Nelson-Piercy C. et al. Chronic histiocytic intervillositis (CHI): current treatments and perinatal outcomes, a systematic review and a meta-analysis. Front. Endocrinol. (Lausanne). 2022: 13: 945543. https://dx.doi.org/10.3389/fendo.2022.945543
- Cornish E.F., McDonnell T., Williams D.J. Chronic inflammatory placental disorders associated with recurrent adverse pregnancy outcome. Front. Immunol. 2022: 13: 825075. https://dx.doi.org/10.3389/fimmu.2022.825075
- Zhang X., Fang Z., Wang X. Gaps in maternal-fetal interface rejection response: chronic histiocytic intervillositis. Front. Immunol. 2025; 16:1625701. https://dx.doi.org/10.3389/fimmu.2025.1625701
- Ghotbi E., Mansouri Z., Azarboo A., Eshraghi N., Ghaemi M., Haddadi M. et al. Placental chronic histiocytic intervillositis: pregnancy outcomes and complications, a systematic review and meta-analysis. Int. J. Gynecol. Pathol. 2026; 45(3): 228-34. https://dx.doi.org/10.1097/PGP.0000000000001148
- Bos M., Koenders M.J.M., Dijkstra K.L., van der Meeren L.E., Nikkels P.G. J., Bloemenkamp K.W.M. et al. The severity of chronic histiocytic intervil-lositis is associated with gestational age and fetal weight. Placenta. 2023: 131: 28-35. https://dx.doi.org/10.1016/j.placenta.2022.11.014
- Mawa A., Bizet G., Stichelbout M., Devisme L., Pauchet M., Gobert S. et al. Caracteristics of women presenting with chronic histiocytic intervillositis during pregnancy: a case-control study. J. Gynecol. Obstet. Hum. Reprod. 2025; 54(2): 102882. https://dx.doi.org/10.1016/j.jogoh.2024.102882
- Gavillet M., Gengler C., Legardeur H., Gannagé M., Puder J., Beauport L. et al. Case report: a novel approach to prevent chronic histiocytic intervillositis and recurrent pregnancy loss by targeting maternal alloimmunity. Front. Immunol. 2025; 16: 1693016. https://dx.doi.org/10.3389/fimmu.2025.1693016
- Albersammer L., Leon J., Martinovic J., Dagobert J., Lebraud E., Bessières B. et al. Histologic and molecular features shared between antibody-mediated rejection of kidney allografts and chronic histiocytic intervillositis support common pathogenesis. J. Pathol. 2025; 266(2): 177-91. https://dx.doi.org/10.1002/path.6413
- Shangaris P., Martín Monreal M.T. Maternal–foetal immune rejection: parallels between placental CHI and allograft rejection. J. Pathol. 2025; 267(2): 121-5. https://dx.doi.org/10.1002/path.6459
- Bell-Ricketts M.J., Porter-Wright I.A., Borovika K., Bowman A., Lombardi G., Nicolaides K.H. et al. Chronic histiocytic intervillositis: Insights into immunopathogenesis and prospective treatments. J. Reprod. Immunol. 2026; 175: 104886. https://dx.doi.org/10.1016/j.jri.2026.104886
- Abisror N., Cheloufi M., Cohen J., Coulomb A., McAvoy Ch., Fain O. et al. Intravenous immunoglobulins for recurrent chronic histiocytic intervillositis: a series of case studies. Am. J. Reprod. Immunol. 2024; 92(1): e13898. https://dx.doi.org/10.1111/aji.13898
- Brady C.A., Williams C., Batra G., Church E., Tower C.L., Crocker I.P. et al. Immunomodulatory therapy reduces the severity of placental lesions in chron-ic histiocytic intervillositis. Front. Med. (Lausanne). 2021; 8: 753220. https://dx.doi.org/10.3389/fmed.2021.753220
Received 21.09.2026
Accepted 07.10.2026
About the Authors
Ekaterina B. Larina, PhD, Head of the Department of Pregnancy Pathology, Lapino Clinical Hospital, Mother and Child Group of Companies,143081, Russia, Moscow Region, Odintsovo District, Lapino, 1st Uspenskoe Highway, 111, eb.larina@mcclinics.ru
Lyudmila A. Shestakova, PhD, Head of the Department of Pathological Anatomy, Lapino Clinical Hospital, Mother and Child Group of Companies,
143081, Russia, Moscow Region, Odintsovo District, Lapino, 1st Uspenskoe Highway, 111.
Mark A. Kurtser, Academician of the Russian Academy of Sciences, Dr. Med. Sci., Professor, General Director of Mother and Child Group of Companies, Moscow, Russia.
Corresponding author: Ekaterina B. Larina, eb.larina@mcclinics.ru
Similar Articles
