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Placenta

Placental gross/microscopic abnormalities, non-neoplastic

Amniotic rupture and Amniotic band syndrome


Reviewers: Mandolin Ziadie, M.D. (see Reviewers page)
Revised: 10 October 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Sporadic rupture of the amniotic sac; theories of pathogenesis vary
● Amniotic rupture is associated with amniotic band syndrome (Am J Surg Pathol 1984;8:117), in which strips of amniotic epithelium wrap around fetal surfaces and cause amputations, necrosis and deformations
● Craniofacial defects and limb abnormalities are the most common results
● Early rupture is associated with more severe fetal defects

Gross description
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● Fetal surface may appear rough
● Residual strips of amnion may be seen but are usually overlooked

Micro description
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● Vernix granulomas in separated amniotic mesenchyme and in denuded mesenchyme of chorionic plates confirm antepartum amniotic rupture
● Biopsies of maternal placental bed may show desquamated stratified squamous epithelial cells in edema fluid between muscle fibers surrounded by marked neutrophilic infiltrate, uterine venules with fibrin clots containing squamous epithelial cells; veins with plugs of amniotic thrombi (Arch Pathol Lab Med 1997;121:167)
● In prolonged amniotic leakage, may see subchorionic squames or subchorionic foreign-body reaction (Arch Pathol Lab Med 1986;110:47)

End of Placenta > Placental gross/microscopic abnormalities, non-neoplastic > Amniotic rupture and Amniotic band syndrome


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