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Rounded intraplacental haematomas due to decidual vasculopathy have a distinctive morphology
  1. Brendan Fitzgerald1,2,
  2. Patrick Shannon1,2,
  3. John Kingdom1,3,4,
  4. Sarah Keating1,2,3
  1. 1Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
  2. 2Department of Pathology & Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada
  3. 3Department of Obstetrics & Gynecology, University of Toronto, Toronto, Canada
  4. 4Department of Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Canada
  1. Correspondence to Dr Sarah Keating, Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada; skeating{at}mtsinai.on.ca

Abstract

Within the placenta, most centrally placed intervillous thrombi are thought to form at sites of foetomaternal haemorrhage, while parabasally located intervillous thombi have been linked to maternal vascular disease. To determine whether parabasally located haemorrhagic lesions were morphologically heterogeneous, the authors performed a retrospective review of 25 placentas with thrombohaematomas occurring in the vicinity of the basal plate. Using morphological criteria, two lesions were distinguished: (1) the parabasally located intervillous thrombus, which had all the morphological features of more centrally located intervillous thrombi; and (2) the rounded intraplacental haematoma. Rounded intraplacental haematomas form as a result of disruption of vasculopathic decidual arterioles in a setting of maternal vascular underperfusion and are thus aetiologically distinct from classically described intervillous thrombi.

  • Intervillous thrombus
  • rounded intraplacental haematoma
  • decidual vasculopathy
  • parabasal placental thrombohaematoma
  • placenta
  • pregnancy

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Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Mount Sinai Hospital Research Ethics Board (reference 10-0259-C).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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