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Placenta

Placental gross/microscopic abnormalities, non-neoplastic

Retroplacental hematoma with intraplacental extension (abruption)


Reviewers: Mandolin Ziadie, M.D. (see Reviewers page)
Revised: 17 November 2011, last major update October 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Hematomas between the basal plate and uterus form due to acute or chronic hemorrhage; if significant (>50%), there is an increased risk of fetal death
● Smaller hematomas pose a risk for vaginal bleeding, oligohydramnios and premature delivery
● The diagnosis of abruption is clinical; findings in the placenta may not be sufficient
● Kleihauer-Betke test for fetal-maternal hemorrhage is NOT recommended for diagnosis (Arch Pathol Lab Med 1995;119:1032)

Gross description
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● Loose blood clots or blood clots tenuously adherent to placental floor if acute
● Remote episodes have brown-tan, old fibrin and necrotic tissue at abruption site and adjacent membranous tissue
● Features of intraplacental extension include pale areas of infarction

Gross images
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Abruptio placenta, with dark red retroplacental blood clot

Micro description
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● Retroplacental hemorrhage or hematomas associated with diffuse intradecidual hemorrhage, villous stromal hemorrhage / edema, intervillous thrombi or infarction
● Chronic hemorrhage may also show hemosiderin staining

Micro images
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Extensive hemorrhage

Diagram
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Diagram

End of Placenta > Placental gross/microscopic abnormalities, non-neoplastic > Retroplacental hematoma with intraplacental extension (abruption)


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