Introduction: Massive chronic intervillositis (MCV) or currently known as chronic intervillositis of unknown aetiology is a rare poorly understood placental lesion. MCV is strongly associated with recurrent spontaneous miscarriages, IUGR and fetal demise. We described a case of MCV in a lady with consecutive recurrent miscarriages. Case report: The patient was a 37-year-old lady who had ten consecutive recurrent first trimester miscarriages within the last 13 years. She has no living child and the relevant blood investigations were not helpful in determining the cause of recurrent miscarriages. Histopathological examination of the conception tissues showed abundant aggregates of CD 68 positive histiocytes primarily within the intervillous spaces associated with increased perivillous fibrin deposition. No significant villitis were seen. The findings were consistent with massive chronic intervillositis. Discussion & conclusion: MCV is associated with high recurrence rate of spontaneous miscarriages. In general, practicing pathologist are unfamiliar with MCV. The histiocytes may be missed during a routine reporting of tissue from products of conception if important clinical informations are not being highlighted to the pathologists. Chronic intervillositis of infectious etiology should be excluded. However the etiology of MCV remains unclear. The histiocytes are maternal in origin which led to the hypothesis of a possible abnormal maternal immune reaction towards the placental tissue in the pathogenesis of MCV. Obstetricians and pathologists should be made aware of this entity. Until today, no proven effective treatment has been proposed to prevent recurrences. Further studies are required in the understanding of this entity and in the prevention of recurrent pregnancy losses.

Introduction: Maternal Floor Infarction (MFI) is an uncommon pathological entity characterised by the presence of massive and diffuse perivillous fibrinoid material in the maternal surface of the placenta. It was first described in the 1960s. MFI has clear associations with intrauterine fetal demise, IUGR and recurrent pregnancy losses. We would like to share two cases of MFI, which had similar clinical presentations. Case reports: Case 1: A 31-year-old lady who is in her sixth pregnancy and at 32 weeks of gestation. She has a history of three intrauterine fetal deaths and two live births. Her recent pregnancy was complicated with IUGR, oligohydramnious and absence of end diastolic flow on Doppler. Case 2: A 34-year-old lady who is in her third pregnancy and at 35 weeks of gestation. Similarly she had IUGR and oligohydramnios. In both cases, the babies were delivered alive by caesarean sections. Tissue examination of both placentas showed extensive fibrin deposition on the decidual floor, extending up into the intervillous spaces with encasement of the villi amounting to MFI. Discussion and Conclusion: Although MFI is uncommon, it has significant perinatal morbidity and mortality with the risk of recurrence. In general, practicing pathologists are unfamiliar with MFI which is macroscopically and microscopically different from ischaemic infarcts. The etiology of MFI is unknown, but evidence support an alloimmune or autoimmune mechanism. Awareness of this old entity and recognizing them on placenta tissue sections would aid in management of future pregnancies and in the adequate follow up of the surviving infants