Author: Vicky

This is a case study (looking at a single person) about a woman in Singapore who had an early miscarriage (around 7 weeks) that appears to have been due to CHI. They note that there are no current clinical guidelines regarding the management of CHI and go on to discuss the current literature and suggestions […]

This paper from the UK gives a detailed and thorough summary of a lot of the current knowledge about CHI. As well as the pathophysiology (the body processes when things go wrong), it covers many things that we already suspect – CHI is a rare condition (6 in 10,000 pregnancies) but that if you are […]

This paper from Malaysia provides pathologists with information about what to look for when examining a placenta after a stillbirth or a miscarriage by discussing a case study of a woman who had several miscarriages and was found to have signs in three of her pregnancies in her placenta of CHI. They describe how lots […]

This is a case-control study: which means they have the ‘cases’ – the people with CHI and they try to find people who are similar in every other way except they don’t have CHI – the ‘controls’, and see how the outcomes for the two groups compare. Unfortunately, it very much suggests that those with […]

This ‘retrospective observational’ study (which means a study where they look at people who were diagnosed with CHI and looked back to see if there was anything special about their pregnancies) looked at 33 pregnancies with confirmed ‘CHI’ in Toronto, Canada. They looked at blood results and ultrasound results as well as the overall health […]

This is a case study series looking at 3 subsequent pregnancies in a woman who has unfortunately had 4 previous early miscarriages and been diagnosed with CHI. They found that pregnancy outcomes changed depending on treatment with the most successful being a combination of low dose aspirin and prednisolone. File: Ozawa et al. – Chronic histiocytic […]

This study looks in detail at the type of immune cells that are found in placentas with CVUE and MCI. It hypotheseses that these might be differing severities of the same underlying pathology. It also explicitly states two different ideas as to what causes CVUE/MCI – either due to the fetus responding to an infectious […]

Reus et al. – An Immunological Basis for Chronic Histiocytic Intervillositis in Recurrent Fetal Loss – 2013 – American Journal of Reproductive Immunology This paper ‘scores’ or grades placentas as to how many/much lesions associated with CHI and finds that a higher score (more lesions) is associated with worse outcomes and is considered to be […]

Changes in expression of the CD200 tolerance-signaling molecule and its receptor (CD200R) by villus trophoblasts during first trimester missed abortion and in chronic histiocytic intervillositis (Clark DA, Dmetrichuk JM, McCready E, et al) – 2017 This paper looks at the immune response in a pregnancy in women with recurrent miscarriage and specifically CHI. It was […]

This New Zealand case report looks at a woman who had recurrent pregnancy loss and was diagnosed with CHI. A subsequent pregnancy was successful with a combination of therapy including: prednisone, enoxaparin, calcium and aspirin, close monitoring with regular growth scans, and an elective c-section at 34 weeks when it was seen the baby’s growth was […]

This Australian paper looks at a single woman who unfortunately had 4 pregnancies affected by CHI. Her fetuses also appeared to have a bone condition (osteogenesis imperfecta – OI) although the histology (looking down a microscope) of the bones didn’t match typical OI and she didn’t have any genetic markers for it either.   Crawford […]

This paper notes the previously known histological (looking down the microscope) similarity between placental malaria and CHI and suggests that they may both result/be due to cells ‘expressing’ receptors on their surface. They looked at cells from CHI placentas as well as cells from normal placentas and those from CVUE placentas and found that there […]

Chronic histiocytic intervillositis: Outcome, associated diseases and treatment in a multicenter prospective study. Citation: Mekinian A, Costedoat-Chalumeau N, Masseau A, et al. Chronic histiocytic intervillositis: Outcome, associated diseases and treatment in a multicenter prospective study. Autoimmunity 2014;6934:1–6. doi:10.3109/08916934.2014.939267 Introduction: In this prospective multicenter study, we aimed to describe (1) the outcome of pregnancy in the case […]

(Summary to come!) Chronic histiocytic intervillositis of unknown etiology: Clinical features in a consecutive series of 69 cases: Marchaudon et. al

This study talks about Chronic intervillositis of unknown etiology (CIUE) which appears to be yet another term for CHI/CHIV/MCI. It looks at 20 pregnancies across 14 women affected by CIUE; 10 resulted in live births and the recurrence rate for multiple pregancies was 100% (it should be noted however, that this is a smaller sample […]

CVUE is thought to be different but a similar and more common disease compared to CHI. It talks about associations with maternal BMI, multiple pregnancies and ethnicity. It also found it showed up in pregnancies affected by autoimmune or alloimmune diseases. It suggests aspirin and corticosteroids as a possible regimen. Chronic villitis of unknown etiology: […]

This talks about Villitis of unknown etiology (VUE) which I guess becomes Chronic Villitis of unknown etiology (CVUE) if you have it for life rather than as a result of an acute condition? It describes how this more common condition can affect 5-15% of pregnancies and, as you’d expect from those sort of numbers, isn’t […]

This study talks about MFD/MFI and CI as similar conditions both of which are very rare. It looks at one case study and talks about how the diseases may be similar. It mentions heparin-type drugs and immunosuppresants as possible treatment options. Its focus is to encourage better diagnosis of this condition to improve standards of […]

This study looks at CHIV in the specific case of neonatal alloimmune thrombocytopenia. It suggests that intravenous immunoglobulin given to the mother may help improve the outcome although the results weren’t statistically significant because there weren’t enough case studies. Chronic villitis in untreated neonatal alloimmune thrombocytopenia: An etiology for severe early intrauterine growth restriction and […]

This covers a specific case of MCI/CHIV in a lady who had 10 recurrent miscarriages in her first and second trimesters (although she also had two live births as well!). They look at each pregnancy and try to find similarities and differences between them. Other than that, it draws many similar conclusions as other studies. […]

This study looks at a treatment in the form of prednisone, aspirin, folate, and progesterone in women who had suffered from more than three miscarriages. It found a statistically significant and positive effect in treating women with this regimen compared to those who weren’t treated. The comment on the study is about how valuable the […]

This is a general paper for pathologists who may need to give a report on a preterm placenta. It talks about lots of different types of issues with placentas and covers of CVUE or VUA as it calls it and also mentions MCI but only very briefly. The placenta in preterm birth: O M Faye-Petersen […]

This study concentrates only on first trimester miscarriages. It identifies CHIV/MCI as one of the features that shows up when the fetus does not appear to have DNA problems (has normal karotypes) and yet a miscarriage took place. Prevalence of Developmental and Inflammatory Lesions in Nonmolar First-Trimester Spontaneous Abortions: Raymond W, Redline, MD, Michael Zaragoza, […]

This describes the processes involved in looking at the placenta to determine possible issues. It talks about CHIV/MCI and how the placenta may look if you have it. It also talks about how MCI can be a placental cause of elevated maternal serum α-fetoprotein. Placental Pathology, a Survival Guide: Drucilla J Roberts (2008)

This looks at 12 different studies relating to pathology of placentas and fetuses after recurrent miscarriages and stillbirths and picks up on different issues that can occur including CHI. It talks about how there isn’t consistent work being done to detect issues such as CHI in pregnancies which, while very rare, is important to do […]