correlation between the clinical diagnosis and histopathological findings of placental abruption

ABSTRACT

The diagnosis of placental abruption is mostly clinical, histopathological diagnosis is poorly sensitive. Acute and chronic inflammatory processes had been proposed to cause placental abruption evidences that supports this remains sparse. To assess the correlation between the clinical diagnosis and histopathological findings of placental abruption and to examine the profile of chronic and acute histological lesions associated with clinical abruption. The study included fifty singleton pregnant women with a suspected clinical diagnosis of placental abruption compared to fifty consecutive normal pregnancies [control group], attending AL -Yarmouk Teaching Hospital over a period of twelve months, from the first of April 2010 to the end of march 2011. Examination of the concordance between clinical indicators for placental abruption with those of a histological diagnosis was done. The profile of acute and chronic lesions was also examined histopathologically. Among the fifty clinically diagnosed placental abruption cases, thirteen percent [fifteen patients] were confirmed as placental abruption based on gross and histological findings. The most common indication leading to a clinical diagnosis of abruption was evidence of retroplacental clot[s] or bleeding . Acute lesions that were associated with abruption with confirmed pathology included chorioamnionitis, and chorionic villous hemorrhage. Among the chronic lesions, chronic deciduitis, decidul vasculopathy, and dysmaturation were associated with pathologically confirmed placental abruption. The relation between clinical and histological diagnosis of placental abruption remains weak. Acute and chronic histological lesions were observed more frequently in placentas of pregnancies complicated by placental abruption than the control cases.