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Difference between revisions of "Placenta"
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[[Image:Human_placenta.jpg|thumb|right|A placenta (fetal aspect) with attached umbilical cord. (WC/Asturnut)]] | |||
The '''placenta''' feeds the developing baby, breathes for it and disposes of its waste. | The '''placenta''' feeds the developing baby, breathes for it and disposes of its waste. | ||
The organ is one that seems to be left behind; at least one review suggests it isn't done so well by general pathologists.<ref name=pmid12033960>{{Cite journal | last1 = Sun | first1 = CC. | last2 = Revell | first2 = VO. | last3 = Belli | first3 = AJ. | last4 = Viscardi | first4 = RM. | title = Discrepancy in pathologic diagnosis of placental lesions. | journal = Arch Pathol Lab Med | volume = 126 | issue = 6 | pages = 706-9 | month = Jun | year = 2002 | doi = 10.1043/0003-9985(2002)1260706:DIPDOP2.0.CO;2 | PMID = 12033960 }}</ref> | The organ is one that seems to be left behind; at least one review suggests it isn't done so well by general pathologists.<ref name=pmid12033960>{{Cite journal | last1 = Sun | first1 = CC. | last2 = Revell | first2 = VO. | last3 = Belli | first3 = AJ. | last4 = Viscardi | first4 = RM. | title = Discrepancy in pathologic diagnosis of placental lesions. | journal = Arch Pathol Lab Med | volume = 126 | issue = 6 | pages = 706-9 | month = Jun | year = 2002 | doi = 10.1043/0003-9985(2002)1260706:DIPDOP2.0.CO;2 | PMID = 12033960 }}</ref> | ||
''Placental pathology'' redirects to this article. | |||
=Clinical= | =Clinical= | ||
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===Linear regression - placental mass-gestational age=== | ===Linear regression - placental mass-gestational age=== | ||
Based on the table in the AFIP book<ref>AFIP Placental pathol. ISBN: 1-881041-89-1. P.312</ref> | Based on the table in the AFIP book<ref>AFIP Placental pathol. ISBN: 1-881041-89-1. P.312</ref> one can generate the following regression lines: | ||
{| class="wikitable" | {| class="wikitable" | ||
| ||'''50%''' ||'''10%''' ||'''90%''' | | ||'''50%''' ||'''10%''' ||'''90%''' | ||
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*Is it required? | *Is it required? | ||
**Sebire and Fox have advocated abandoning the practise of obtaining a placental mass, due to the large number of uncontrolled variables inherent in these measures. Instead, they have advocated using mushy descriptors such as "small", "average" and "large", which require experience in examining the organ.<ref>{{cite book |author= Fox, Harold; Sebire, Neil J. |title=[http://www.amazon.com/Pathology-Placenta-Major-Problems/dp/1416025928/ref=sr_1_fkmr0_1?ie=UTF8&qid=1297259619&sr=1-1-fkmr0 Pathology of the Placenta (Major Problems in Pathology)]|publisher=Saunders |location= |year=2007 |pages= 559-561 |edition=3rd |isbn=978-1416025924 |oclc= |doi= |accessdate=}}</ref> | **Sebire and Fox have advocated abandoning the practise of obtaining a placental mass, due to the large number of uncontrolled variables inherent in these measures. Instead, they have advocated using mushy descriptors such as "small", "average" and "large", which require experience in examining the organ.<ref>{{cite book |author= Fox, Harold; Sebire, Neil J. |title=[http://www.amazon.com/Pathology-Placenta-Major-Problems/dp/1416025928/ref=sr_1_fkmr0_1?ie=UTF8&qid=1297259619&sr=1-1-fkmr0 Pathology of the Placenta (Major Problems in Pathology)]|publisher=Saunders |location= |year=2007 |pages= 559-561 |edition=3rd |isbn=978-1416025924 |oclc= |doi= |accessdate=}}</ref> | ||
***In the context of quality, a measure (even if somewhat flawed) | ***In the context of quality, a measure (even if somewhat flawed) is probably more reproducible and objective than arbitrary descriptors which require experience and a continuing case volume to calibrate. | ||
===Placentomegaly=== | ===Placentomegaly=== | ||
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*[[AKA]] ''two vessel cord''. | *[[AKA]] ''two vessel cord''. | ||
*[[AKA]] ''single umbilical artery''. | *[[AKA]] ''single umbilical artery''. | ||
{{Main|Two vessel umbilical cord}} | |||
==Insertion== | ==Insertion== | ||
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*Rare ~ 1/5500. | *Rare ~ 1/5500. | ||
*Mortality ~50% is severe. | *Mortality ~50% is severe. | ||
=Membranes= | =Membranes= | ||
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==Amnion nodosum== | ==Amnion nodosum== | ||
{{Main|Amnion nodosum}} | |||
==Placental meconium== | ==Placental meconium== | ||
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===Gross=== | ===Gross=== | ||
Features:<ref name=pmid18081444/> | Features:<ref name=pmid18081444>{{Cite journal | last1 = Adeniran | first1 = AJ. | last2 = Stanek | first2 = J. | title = Amnion nodosum revisited: clinicopathologic and placental correlations. | journal = Arch Pathol Lab Med | volume = 131 | issue = 12 | pages = 1829-33 | month = Dec | year = 2007 | doi = 10.1043/1543-2165(2007)131[1829:ANRCAP]2.0.CO;2 | PMID = 18081444 }}</ref> | ||
*White (or yellow) plaques - irregular outline. | *White (or yellow) plaques - irregular outline. | ||
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==Funisitis== | ==Funisitis== | ||
{{Main|Funisitis}} | |||
* | *Inflammation of Wharton's jelly - the connective tissue of the umbilical cord. | ||
==Acute villitis== | ==Acute villitis== | ||
{{main|Acute villitis}} | |||
==Villitis of unknown etiology== | ==Villitis of unknown etiology== | ||
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*Abbreviation ''PFD''. | *Abbreviation ''PFD''. | ||
===General=== | ===General=== | ||
*Thought to be an immunologic problem - resulting in platelet activation and fibrin deposition.<ref name=pmid12066949/> | *Thought to be an immunologic problem - resulting in platelet activation and fibrin deposition.<ref name=pmid12066949>{{Cite journal | last1 = Sebire | first1 = NJ. | last2 = Backos | first2 = M. | last3 = Goldin | first3 = RD. | last4 = Regan | first4 = L. | title = Placental massive perivillous fibrin deposition associated with antiphospholipid antibody syndrome. | journal = BJOG | volume = 109 | issue = 5 | pages = 570-3 | month = May | year = 2002 | doi = | PMID = 12066949 }}</ref> | ||
*May be associated with [[diabetes mellitus]].<ref name=Ref_Placenta327>{{Ref Placenta|327}}</ref> | *May be associated with [[diabetes mellitus]].<ref name=Ref_Placenta327>{{Ref Placenta|327}}</ref> | ||
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*Formally ''placental maternal floor infarction''. | *Formally ''placental maternal floor infarction''. | ||
*[[AKA]] ''massive perivillous fibrin deposition''.<ref name=Ref_Placenta367>{{Ref Placenta|367}}</ref> | *[[AKA]] ''massive perivillous fibrin deposition''.<ref name=Ref_Placenta367>{{Ref Placenta|367}}</ref> | ||
{{Main|Maternal floor infarction}} | |||
=Fetal disease= | =Fetal disease= | ||
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*May be spelled ''foetus papyraceus''. | *May be spelled ''foetus papyraceus''. | ||
*[[AKA]] ''fetus compressus''. | *[[AKA]] ''fetus compressus''. | ||
{{Main|Fetus papyraceus}} | |||
==Placental mesenchymal dysplasia== | ==Placental mesenchymal dysplasia== | ||