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Difference between revisions of "Talk:Placenta"
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→Decidual inflammation: new section
(Created page with "==Infarcts== ===Gross description=== The specimen consists of a singleton placenta, received fresh in a container with patient identifiers. Umbilical Cord: *No. of segments: one...") |
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==Placenta checklist== | |||
Membranes: | |||
*Chorioamnionitis/membranitis? | |||
*Meconium? | |||
*Vascular changes? | |||
Cord: | |||
*Vasculitis? | |||
*Funisitis? | |||
Disc: | |||
*Large villi? | |||
**Appropriate for GA? | |||
**Villitis? | |||
**Vascular pathology? | |||
*Vascular villi - [[chorangiosis]]? | |||
*Lesions present on gross? | |||
*Villitis - high power. | |||
**Lymphocytes? | |||
**Plasma cells? | |||
General: | |||
*Size of placenta appropriate for GA? | |||
==Infarcts== | ==Infarcts== | ||
===Gross description=== | ===Gross description=== | ||
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Comment #2 | Comment #2 | ||
The extent of the villitis suggests this finding is probably inconsequential; however, it should be noted that severe lymphohistiocytic villitis is associated with adverse pregnancy outcomes, in a subset of patients. | The extent of the villitis suggests this finding is probably inconsequential; however, it should be noted that severe lymphohistiocytic villitis is associated with adverse pregnancy outcomes, in a subset of patients. | ||
== Chorangiosis? Hypertrophic decidual vasculopathy? == | |||
===Diagnosis=== | |||
PLACENTA, BIRTH:<br> | |||
- THREE VESSEL CORD.<br> | |||
- SMALL SUBCHORIONIC HEMORRHAGE.<br> | |||
- NORMAL THIRD TRIMESTER VILLI AND VILLI WITH FEATURES SUGGESTIVE OF CHORANGIOSIS, SEE COMMENT 1.<br> | |||
- NEGATIVE FOR CHORIOAMNIONITIS AND NEGATIVE FOR MECONIUM.<br> | |||
- THICK-WALLED MATERNAL VESSELS (LACK OF PHYSIOLOGIC CONVERSION), SEE COMMENT 2. | |||
===Comment=== | |||
Comment 1: | |||
Villi, focally, have increased vascular channels; however, they are the appropriate size, for the gestational age, and have peripheral vessels. | |||
Comment 2: | |||
Lack of physiologic conversion (of the spiral arteries of the uterus) is a feature seen in hypertrophic decidual vasculopathy (the histopathologic correlate of gestational hypertension). Other changes of hypertrophic decidual vasculopathy (atherosis, intimal hyperplasia, fibrinoid necrosis of the vessel wall, perivascular inflammation, thrombosis) are absent. | |||
== Decidual inflammation == | |||
<pre> | |||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: | |||
- FETAL MEMBRANES WITH MILD DECIDUAL INFLAMMATION (LYMPHOCYTES AND NEUTROPHILS), | |||
OTHERWISE WITHIN NORMAL LIMITS. | |||
- PLACENTAL DISC WITH THIRD TRIMESTER VILLI, MILD PERIVILLOUS FIBRIN DEPOSITION AND | |||
SUBCHORIONIC FIBRIN (1 CM MAXIMAL DIMENSION). | |||
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | |||
</pre> | |||