Macroscopic Abnormalities of the Placenta

Fox, H.; Sebire, Neil J

doi:10.1016/b978-1-4160-2592-4.50010-2

Cited by 13 publications

(11 citation statements)

References 230 publications

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“…Placental infarcts are mainly due to: a) occlusion of spiral arteries by thrombus; b) strangulation of the placental villi due to increased perivillous or intervillous fibrin/fibrinoid deposition; and c) impairment of the fetal circulation due to fetal thrombotic vasculopathy [22, 25-28]. Placental infarcts can be documented in approximately 20% of uncomplicated pregnancies and in 70% and 40% of patients with severe and mild preeclampsia, respectively [29-31].…”

Section: Commentmentioning

confidence: 99%

Prenatal Diagnosis of a Placental Infarction Hematoma Associated with Fetal Growth Restriction, Preeclampsia and Fetal Death: Clinicopathological Correlation

et al. 2014

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The lesion termed ‘placental infarction hematoma' is associated with fetal death and adverse perinatal outcome. Such a lesion has been associated with a high risk of fetal death and abruption placentae. The fetal and placental hemodynamic changes associated with placental infarction hematoma have not been reported. This paper describes a case of early and severe growth restriction with preeclampsia, and progressive deterioration of the fetal and placental Doppler parameters in the presence of a placental infarction hematoma.

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Section: Commentmentioning

confidence: 99%

Prenatal Diagnosis of a Placental Infarction Hematoma Associated with Fetal Growth Restriction, Preeclampsia and Fetal Death: Clinicopathological Correlation

et al. 2014

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“…In conclusion, we have shown in-vivo formation of an intervillous hemorrhage with correlating ultrasound and pathological diagnoses. While approximately 36% of term placentae show small thromboses of no clinical consequence 4 , we postulate that severe or prolonged intervillous bleeding could be an etiology of fetomaternal hemorrhage. The grayscale sonographic and power Doppler findings should help clinicians to recognize this phenomenon as it occurs and, consequently, monitor and manage affected cases appropriately.…”

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confidence: 75%

Sonographic visualization of in‐vivo formation of intervillous (Kline's) hemorrhage

Paladini

Donarini

Buffelli

et al. 2017

Ultrasound in Obstet & Gyne

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“…Previous studies have shown that pathology findings consistent with placental abruption are more common than clinical diagnoses 5,29 . Some have suggested that placental pathology‐based abruption‐related findings may be inconsequential in the absence of clinical suspicion, given that most pregnancies with such findings have unremarkable outcomes 6 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that pathology findings consistent with placental abruption are more common than clinical diagnoses. 5,29 Some have suggested that placental pathology-based abruption-related findings may be inconsequential in the absence of clinical suspicion, given that most pregnancies with such findings have unremarkable outcomes. 6 In the POUCH Study, two types of evidence of PH from pathology examinations-disc-impacting blood clot (prevalence 5.6%) and microscopic haemorrhage (prevalence 20.4%, based on a distributional cut-point)were clearly more common than placental abruption cases (prevalence 2.0%), and the majority of women with discimpacting blood clots and high microscopic haemorrhage scores delivered at term without placental abruption.…”

Section: Discussionmentioning

confidence: 99%

“…Vaginal bleeding in early to mid‐pregnancy has been associated with PTD in many studies 2–4 . Placental abruption, or premature separation of a normally placed placenta, may originate with bleeding into the decidua from ruptured decidual blood vessels 5 and can result in major obstetric haemorrhage 6 . Placental abruption is present in a larger proportion of preterm deliveries than term deliveries 7,8 .…”

Section: Introductionmentioning

confidence: 99%

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Evidence of placental haemorrhage and preterm delivery

Gargano

Holzman

Senagore

et al. 2010

BJOG

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Please cite this paper as: Gargano J, Holzman C, Senagore P, Reuss M, Pathak D, Williams M, Fisher R. Evidence of placental haemorrhage and preterm delivery. BJOG 2010;117:445–455. Objective To evaluate evidence of placental haemorrhage (PH) obtained through maternal interviews, patient charts and placental pathology examinations as potential indicators of a ‘bleeding pathway’ to preterm delivery (PTD). Design Prospective cohort. Setting Fifty‐two clinics in five communities in Michigan, USA (1998–2004). Population A subset (n = 996) of cohort participants with complete placental pathology data. Methods First‐trimester bleeding and placental abruption were ascertained by mid‐trimester interviews and chart review, respectively. Disc‐impacting blood clot was defined as a gross placental examination finding of a blood clot impacting adjacent tissue. Microscopic haemorrhage was defined as ‘high’ (top quintile) scores on an aggregate measure of placental pathology findings suggestive of atypical maternal vessel haemorrhage. These four PH indicators were compared with one another and with risk of PTD assessed by logistic regression analyses. Main outcome measures Preterm delivery and PTD subtypes (i.e. <35 weeks, 35–36 weeks; spontaneous, medically indicated) compared with term deliveries. Results Placental abruption cases had 2.3‐fold to 5.5‐fold increased odds of the other three PH indicators. Disc‐impacting blood clots and microscopic haemorrhage were associated with one another (odds ratio [OR] = 4.6), but not with first‐trimester bleeding. In a multivariable model that included all four PH indicators and confounders, risk of PTD < 35 weeks was elevated with first‐trimester bleeding (OR = 1.9 [1.0, 3.4]), placental abruption (OR = 5.2 [1.7, 16.2]), disc‐impacting blood clots (OR = 2.3 [1.0, 5.0]) and microscopic haemorrhage (OR = 2.4 [1.4, 4.2]). Conclusions Multiple clinical and subclinical PH indicators are associated with PTD, particularly early PTD.

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Macroscopic Abnormalities of the Placenta

Cited by 13 publications

References 230 publications

Prenatal Diagnosis of a Placental Infarction Hematoma Associated with Fetal Growth Restriction, Preeclampsia and Fetal Death: Clinicopathological Correlation

Prenatal Diagnosis of a Placental Infarction Hematoma Associated with Fetal Growth Restriction, Preeclampsia and Fetal Death: Clinicopathological Correlation

Sonographic visualization of in‐vivo formation of intervillous (Kline's) hemorrhage

Evidence of placental haemorrhage and preterm delivery

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