Difference between revisions of "Placenta"

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Placenta (view source)

Revision as of 17:27, 25 June 2014

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→‎Placental abruption
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==Placental abruption==
==Placental abruption==
===General===
{{Main|Placental abruption}}
Classic clinical manifestations:<ref name=pmid16752262>{{cite journal |author=Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O |title=Clinical presentation and risk factors of placental abruption |journal=Acta Obstet Gynecol Scand |volume=85 |issue=6 |pages=700–5 |year=2006 |pmid=16752262 |doi=10.1080/00016340500449915 |url=}}</ref>
*Vaginal bleeding (~70%).
*Abdominal pain (~50%).
*Fetal heart rate abnormalities (~70%).
 
Sign-out:
*Pathologists should sign-out this as "focal adherent retroplacental hematoma".
**The pathologic findings may be due to abruption or manual removal of the placenta.
 
===Gross===
Features:<ref>CS. 7 February 2011.</ref>
*Large adherent blood clot.
*Disc depression on maternal side.
 
Notes:
*Loosely attached clot less convincing.
*Central haemorrhage is the most worrisome.
 
===Microscopic===
Features:
#Decidual hemorrhage.
#*Blood in the decidua.
#Intravillous hemorrhage, [[AKA]] villous stromal hemorrhage.
#*"Bags of blood" - blood outside of vessels in the villi.
#**Should not be confused with congested villi.
 
Notes:
*There are '''no''' definitive microscopic findings for placental abruption.
*Intravillous hemorrhage is non-specific - may arise in the following: early placental infarct, cord compression, abdominal trauma.
===Sign out===
====Usual nonspecific findings====
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.
- PLACENTAL DISC WITH THIRD TRIMESTER VILLI, TWO SMALL PLACENTAL INFARCTS
  (0.8 CM AND 0.5 CM IN MAXIMAL DIMENSION) AND FOCAL PROMINENCE OF SYNCYTIAL KNOTS.
 
COMMENT:
There is no decidual hemorrhage or intravillous hemorrhage. The prominent syncytial knots
are a nonspecific finding suggestive of (focal) ischemia.
</pre>
Note:
*The above is not diagnostic nor does it exclude the diagnosis of abruption.


=Inflammatory pathologies=
=Inflammatory pathologies=
Michael
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