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| Abruption |
| Etiology • Trauma including accidents and amniocentesis • Decidual vascular pathology associated with preeclampsia or anticardiolipin antibodies • Abnormal uterine shape • Placenta praevia • Cocaine |
| Pathogenesis • Separation of the placenta by retroplacental hemorrhage from the uterus prior to delivery of the fetus. • Hemorrhage may extend into the intervillous space • Compression with hemorrhage in the villus stroma and/or infarct may occur • Secondary to vascular rupture (fibrinoid necrosis), sudden vascular hypertension with bleeding (cocaine?) or vascular thrombosis, |
| Epidemiology • <1% of pregnancies based on clinician's estimate • 2-4% of placentas examined microscopically show some evidence of abruption |
| General Gross Description • Retroplacental blood clot which may be very adherent to maternal surface • May be compression and infarct of adjacent villi. |
| General Microscopic Description • Clot may vary from acute to old although it will not organize • Villi may show hemorrhage into the stroma • Villous infarcts may be seen. |
| Clinical Correlation • Present with abdominal pain and vaginal bleeding • Extent of vaginal bleeding may depend on location of rupture (marginal or central) • Hemorrhage may be substantial and result in fetal mortality. |
| References • Benirschke K, Kaufmann P. Pathology of the human placenta, 3rd ed. New York: Springer-Verlag, 1995, pp. 496-508. |
| Abruption |
| Synopsis by: Melinda Sanders M.D. (T88100M29360)[63] |
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