Chorion laeve accreta - Another manifestation of morbid adherence
| Autor: | Debra S. Heller, Stewart F. Cramer, T. Y. Khong |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Pathology medicine.medical_specialty Placenta accreta Placenta Placenta Accreta Hysterectomy 03 medical and health sciences Young Adult 0302 clinical medicine Fetal membrane Pregnancy medicine Humans reproductive and urinary physiology Fetus 030219 obstetrics & reproductive medicine postpartum bleeding business.industry Decidua Myometrium Obstetrics and Gynecology Muscle Smooth medicine.disease medicine.anatomical_structure Reproductive Medicine 030220 oncology & carcinogenesis Hemosiderin embryonic structures Female business Placenta Retained Developmental Biology |
| Zdroj: | Placenta. 74 |
| ISSN: | 1532-3102 |
| Popis: | Introduction Smooth muscle in the decidua of fetal membranes (membrane myofibers, MMF) is not mentioned in standard textbooks. Methods The current report presents collected observations on 52 patients with MMF at 2 institutions between 2004 and 2017 - including placentas, postpartum curettages, and hysterectomies. Results Clinical presentations include observation of adherent membranes during delivery, disrupted and incomplete membranes in placentas submitted for examination, postpartum bleeding associated with retained fetal membranes, association with membrane hematomas and membrane hemosiderin, morbidly adherent fetal membranes in hysterectomies; and association with grossly adherent pieces of tissue or nodules in fetal membranes. Discussion Although MMF can be an incidental microscopic observation in a routine placenta, the suggested diagnostic terminology when there are clinical and/or gross presentations is Chorion Laeve Accreta (ChLA). Further study is needed but MMF appears to be the fetal membrane counterpart of BPMF(basal plate myofibers), possibly due to damage of subjacent myometrium by trophoblastic proteases, so that shear stress during delivery causes myofibers to come out attached to the decidua of fetal membranes. Neither the prevalence of MMF, nor its reliability as a marker for placenta accreta is addressed in this collection. Association of MMF with BPMF, and recurrence of MMF, are documented; but the true frequency of these phenomena remains to be established. |
| Databáze: | OpenAIRE |
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