Difference between revisions of "Placenta"

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Placenta (view source)

Revision as of 02:27, 5 June 2015

3,998 bytes removed ,  02:27, 5 June 2015
→‎Maternal floor infarction: split out
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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>
===General===
{{Main|Maternal floor infarction}}
*'''''Not''''' a true infact.
**It is really fibrin deposition.<ref name=Ref_TPoSP178>{{Ref TPoSP|178}}</ref>
 
Associations:
*[[Intrauterine growth restriction]] (IUGR).<ref name=pmid18641412>{{Cite journal  | last1 = Roberts | first1 = DJ. | last2 = Post | first2 = MD. | title = The placenta in pre-eclampsia and intrauterine growth restriction. | journal = J Clin Pathol | volume = 61 | issue = 12 | pages = 1254-60 | month = Dec | year = 2008 | doi = 10.1136/jcp.2008.055236 | PMID = 18641412 }}</ref><ref name=pmid11910510>{{Cite journal  | last1 = Katzman | first1 = PJ. | last2 = Genest | first2 = DR. | title = Maternal floor infarction and massive perivillous fibrin deposition: histological definitions, association with intrauterine fetal growth restriction, and risk of recurrence. | journal = Pediatr Dev Pathol | volume = 5 | issue = 2 | pages = 159-64 | month =  | year =  | doi = 10.1007/s10024-001-0195-y | PMID = 11910510 }}</ref>
*Anti-phospholipid antibody (APLA) syndrome.<ref name=pmid12066949>{{cite journal |author=Sebire NJ, Backos M, Goldin RD, Regan L |title=Placental massive perivillous fibrin deposition associated with antiphospholipid antibody syndrome |journal=BJOG |volume=109 |issue=5 |pages=570–3 |year=2002 |month=May |pmid=12066949 |doi= |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1470-0328&date=2002&volume=109&issue=5&spage=570}}</ref>
**APLA is associated with recurrent miscarriage - can be treated with heparin + ASA.<ref name=pmid12066949/>
*Pregnancy-induced [[hypertension]].<ref name=pmid8569189>{{Cite journal  | last1 = Kanfer | first1 = A. | last2 = Bruch | first2 = JF. | last3 = Nguyen | first3 = G. | last4 = He | first4 = CJ. | last5 = Delarue | first5 = F. | last6 = Flahault | first6 = A. | last7 = Nessmann | first7 = C. | last8 = Uzan | first8 = S. | title = Increased placental antifibrinolytic potential and fibrin deposits in pregnancy-induced hypertension and preeclampsia. | journal = Lab Invest | volume = 74 | issue = 1 | pages = 253-8 | month = Jan | year = 1996 | doi =  | PMID = 8569189 }}</ref>
 
===Gross===
Features:<ref name=Ref_Placenta368>{{Ref Placenta|368}}</ref>
*+/-Thickened placenta.
*Maternal aspect of placental disc irregular or lobulated appearance.
*+/-Yellowish discolourization.
 
===Microscopic===
Features:
*Extensive fibrin deposition around villi on maternal aspect - see: ''[[Perivillous fibrin deposition]]''.
**Described as having a "net-like" pattern.<ref name=Ref_Placenta368>{{Ref Placenta|368}}</ref>
**"Extensive" - either of the following:<ref name=pmid11910510/><ref>AFIP - Placental Pathology. P.135. ISBN: 1-881041-89-1. 2004.</ref>
**#Micro: one slide with >50% of villi involved.
**#*Gross: full thickness involvement.
**#Micro: maternal floor has at least 3 mm of fibrin on one slide.
**#*Gross: maternal floor diffusely involved.
 
DDx:
*[[Perivillous fibrin deposition]] - less perivillous fibrin.
*[[Placental infarction]].
 
Images:
*[http://www.flickr.com/photos/jian-hua_qiao_md/3987724630/ Maternal floor infarct (flickr.com)].
*[http://www.flickr.com/photos/jian-hua_qiao_md/3986970923/ Maternal floor infarct (flickr.com)].
*[http://path.upmc.edu/cases/case224.html Maternal floor infarct - several images (upmc.edu)].
 
===Sign out===
<pre>
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH:
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS.
- FETAL MEMBRANES WITHIN NORMAL LIMITS.
- SMALL PLACENTAL DISC WITH MASSIVE PERIVILLOUS FIBRIN DEPOSITION, SEE COMMENT.
 
COMMENT:
Massive perivillous fibrin deposition (MPVFD) is associated with intrauterine
growth restriction (IUGR). MPVFD is described in association with in
anti-phospholipid antibody (APLA) syndrome, pregnancy-induced hypertension and
congenital infections. Perivillous fibrin deposition may be seen in diabetes.
 
There is no apparent infection. Changes suggestive of decidual vasculopathy
are not apparent. Changes suggestive of fetal thrombotic vasculopathy are
not identified.
</pre>


=Fetal disease=
=Fetal disease=
Michael
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