Rupture of the basal (decidual) plate in abruptio placentae: a pathway of autoextraction from the decidua into the maternal circulation.

摘要: Abstract Two selected retroplacental hematomas, each still in situ on its delivered placenta, were studied microscopic sections. One was a self-limiting hematoma from case of eclampsia, the other an extensive clinically diagnosed abruptio placentae. Thus these represented early and late stage progress In basal plate which otherwise separates communication with maternal lake found to be lacerated. These spontaneous lacerations appeared result expanding force within itself. It inferred that at time rupture blood may have returned through laceration into lake, thence back general circulation. further this provided pathway for autoextraction decidual tissue substances A comparable mechansim auto-extraction during placenta previa, marginal separation or sinus seems improbable because appreciable return flow circulation is lacking. The implications apparent autoextraction, as etiological factor acute disorders placentae, upon therapy are considered. reaffirmed placentae delivery usually should accomplished promptly, even resort cesarean section if vaginal not imminent. This reduce risk complications therefrom, including release activation coagulation More importantly, whatever obstetrical management, it becomes mandatory, once clinical diagnosis made, immediately initiate "stand-by" preparations restoration circulating mechanism (and loss). Need become acutely manifest delivery, before after. danger defibrination secondary intravascular coagulation, failure thereby hemostasis. Not prepared large quantities already cross-matched blood, or, lacking this, support mechanism, run fatal hemorrhage minor incisions perineal abdominal surgery delivery. Because extension premature placental separation, important simultaneous with, prior to,