| The basal plate is at the top of the image.
The black arrows point to a golden yellow discoloration composed of hemosiderin.
Beneath the hemosiderin is an area of old thrombus.
Villi may be seen in the lower right hand corner of the image. |
| 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 |
| Clinical |
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. |
| General Gross Description |
Retroplacental blood clot which may be very adherent to maternal surface May be compression and infarct of adjacent villi. |
| General Micro 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. |
| Reference |
Benirschke K, Kaufmann P. Pathology of the human placenta, 3rd ed. New York: Springer-Verlag, 1995, pp. 496-508.
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