HCMV antigens can induce an innate immune response via a Toll-like receptor 2-dependent mechanism and cause placental inflammation without direct infection.6,7 Inflammation can cause large fibrinoids with many avascular or edematous villi, as seen in our cases, which could reduce perfusion and transport of substances across the placenta.10 Pereira et al. Here, TLR2 is linked to infection.