The fetal heart was not heard, and ultrasound confirmed intrauterine death, severe growth impairment and a retroplacental
Clinical significance of subchorionic and retroplacental
hematomas detected in the first trimester of pregnancy.
Some significant placental diagnoses can be suspected by a focused and careful gross examination of the placenta, requiring no histopathologic resources, for example, velamentous cord insertion, retroplacental
hematomas suggesting acute or chronic abruption, and placental infarcts (Tables 2 and 3).
On grey-scale ultrasound imaging, 10x7 cm placental tissue was visualised with loss of the retroplacental
In a previous study, the incidence of first-trimester subchorionic and retroplacental
hematomas was 3% in a general obstetric population (Obstet.
8) In conditions associated with maternal hypoperfusion the placenta may show perivillous fibrinoid deposition, subchorionic fibrinoid plaque, massive subchorial thrombosis, basal intervillous thrombus, intervillous lakes, retroplacental
haematomas, maternal surface chorionic villous infarction and syncytial knots.
57,84) Early coagulation necrosis of the placenta underlying a retroplacental
hematoma of placental abruption begins in 4 to 24 hours (13) but is not complete after more than 24 hours.
One of the first two authors then verified the information on the woman's hospital chart to ensure that the inclusion criteria (a retroplacental
blood clot covering [greater than or equal to] 15% of the placental surface, gestational age [greater than or equal to] 24 weeks, coloured population and singleton pregnancy) and exclusion criteria (multiple pregnancy, other causes of antepartum haemorrhage and poor knowledge of Afrikaans or English, the languages in which the interviews were conducted) were applied.
Mild neutrophilic infiltrate, immature villi with retroplacental
haemorrhage, No thrombus.
4) We ascribe our case to the latter since, although the patient presented with vaginal bleeding and had a rapid fetal death suggestive of abruptio placentae, she never went into shock, and examination of the placenta did not reveal any retroplacental
Two placentas showed massive retroplacental
hematomas; seven showed extensive infarction; and four exhibited large dilated vascular cavitations, severe vasculitis, chorioamnionitis, and funiculitis.
hematomas were more common in groups 1 and 2 (hypoxic disc lesions), which is not surprising because of their known associations with placental infarctions and preeclampsia.