Department of Gynaecology and Obstetrics, Faculty of Medicine, Sebha University, Sebha, Libya.
Sebha Univ. J. Med. Sci. 2002, Vol. 3(1):50-54
Abruptio placenta is initiated by bleeding into the decidua basalis. In most cases, the sources of bleeding are small arterial vessels in the basal layer of the decidua that are pathologically altered and prone to rupture; such a disturbance could trigger the events leading to abruptio. Many factors cause abruptio placenta, but a single causative has not been identified. The diagnosis is based on clinical, ultrasonographic and pathologic findings. Ultrasound diagnosis reveals only 7.7% of abruptio placenta as a retroplacental hematoma. Pathologic diagnosis is based on gross and microscopic examinations of the placenta which show that part of the placenta has been detached, being brown, shrunken, and more solid than the rest, and having an old clot adherent to it.
The finding depends on the time between separation and delivery of the placenta; if separation occurs a few minutes before delivery, the placenta may appear completely normal. Naeye lists histologic criteria that provide evidence that a retroplacental hematoma has been present before labor: clot lamination, decidual acute inflammatory cell infiltrate, adjacent decidual necrosis and disappearance of the intervillous space with crowding of the villi.
Keywords: Histopathological Examination of 65 Cases of Abruptio Placenta