Placental bed biopsies in placental abruption

Abstract

Objective association with placental abruption. Design Prospective descriptive study. Subjects 18 women with clinical evidence of severe placental abruption delivered by caesarean section. Interventions Placental bed biopsies were obtained at caesarean section and studied histologically. Results Six specimens did not include trophoblast in the myometrium and were therefore not representative of the placental bed. Of the 12 representative specimens, seven demonstrated absence of physiological transformation of the utero-placental arteries (four of these were from hypertensive patients). Four biopsies showed abnormal vascular structures deep in the myometrium. One of these abnormal vessels included a fresh plug and extensive surrounding intramyometrial haemorrhage. Conclusions Vascular malformations in association with placental abruption may be the result of trophoblastic invasion and could be the site of vessel rupture. Further descriptive and comparative studies are needed. J Path B0c.t 93, 569-579.

Hyperhomocysteinemia: a risk factor for placental abruption or infarction

“…Histologic examination of the spiral arteries in placental infarction usually reveals one or more signs of vasculopathy, i.e. atherosis, narrowing, necrosis and thrombosis [19][20][21][22][23].…”

Diagnosis of Placental Abruption: Relationship Between Clinical and Histopathological Findings

“…Over half of all pregnancies complicated by abruption deliver preterm (4)(5)(6), and abruption is associated with an array of adverse maternal and fetal outcomes (7)(8)(9). The etiology of placental abruption remains speculative but is thought to be the consequence of abnormal trophoblast invasion leading to rupture of the spiral arteries and premature separation of the placenta (10).…”

O leito placentário no descolamento prematuro da placenta

“…15 relataram, respectivamente, a exclusão de 23,2 e 34,4% das amostras colhidas, por não serem representativas do leito placentário. Acreditamos que biópsia realizada com técnicas inadequadas isto é, nas áreas periféricas do sítio de implantação e/ou em profundidade menor ou igual a 0,5 cm, teriam maior probabilidade de serem insuficientes para representar todo o tecido placentário, além de apresentar distribuição irregular do trofoblasto neste nível.…”