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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>
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| *Vaginal bleeding (~70%).
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| *Abdominal pain (~50%).
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| *Fetal heart rate abnormalities (~70%).
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| Sign-out:
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| *Pathologists should sign-out this as "focal adherent retroplacental hematoma".
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| **The pathologic findings may be due to abruption or manual removal of the placenta.
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| ===Gross===
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| Features:<ref>CS. 7 February 2011.</ref>
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| *Large adherent blood clot.
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| *Disc depression on maternal side.
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| Notes:
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| *Loosely attached clot less convincing.
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| *Central haemorrhage is the most worrisome.
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| ===Microscopic===
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| Features:
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| #Decidual hemorrhage.
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| #*Blood in the decidua.
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| #Intravillous hemorrhage, [[AKA]] villous stromal hemorrhage.
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| #*"Bags of blood" - blood outside of vessels in the villi.
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| #**Should not be confused with congested villi.
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| Notes:
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| *There are '''no''' definitive microscopic findings for placental abruption.
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| *Intravillous hemorrhage is non-specific - may arise in the following: early placental infarct, cord compression, abdominal trauma.
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| ===Sign out===
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| ====Usual nonspecific findings====
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| <pre>
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| PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
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| - THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
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| - FETAL MEMBRANES WITHIN NORMAL LIMITS.
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| - PLACENTAL DISC WITH THIRD TRIMESTER VILLI, TWO SMALL PLACENTAL INFARCTS
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| (0.8 CM AND 0.5 CM IN MAXIMAL DIMENSION) AND FOCAL PROMINENCE OF SYNCYTIAL KNOTS.
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| COMMENT:
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| There is no decidual hemorrhage or intravillous hemorrhage. The prominent syncytial knots
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| are a nonspecific finding suggestive of (focal) ischemia.
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| </pre>
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| Note:
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| *The above is not diagnostic nor does it exclude the diagnosis of abruption.
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| =Inflammatory pathologies= | | =Inflammatory pathologies= |