The effect of maternal thrombophilia on placental abruption: Histologic correlates.
Publication/Presentation Date
3-1-2009
Abstract
OBJECTIVE: To determine if the histology of placental abruption differs by maternal thrombophilia status.
STUDY DESIGN: This was a multicentre, case-control study of women with abruption and delivering at >or=20 weeks' gestation, collected as part of the ongoing New Jersey-placental abruption study. Women were identified by clinical criteria of abruption. Maternal blood was collected postpartum and tested for anticardiolipin antibodies, and mutations in the Factor V Leiden and prothrombin genes. Cases were comprised of women with an abruption and a positive thrombophilia screen. Controls were comprised of women with an abruption and a negative thrombophilia screen. All placental histology was systematically reviewed by two perinatal pathologists, blinded to the abruption status.
RESULTS: A total of 135 women with placental abruption were identified, of which 63.0% (n = 85) had at least one diagnosed maternal thrombophilia. There were increases in the rates of meconium-stained membranes (7.9%vs. 2.1%, p = 0.015) and decidual necrosis (4.5%vs. 2.1%, p = 0.023) when a maternal thrombophilia was diagnosed. Although there was no difference in the overall presence of infarcts between the two groups (27.0%vs. 38.3%, p = 0.064), the presence of an old infarct was more common among women with a positive thrombophilia screen (83.3%vs. 44.4%, p = 0.003).
CONCLUSION: Placental abruption with a positive maternal thrombophilia screen is associated with higher rates of old placental infarcts and decidual necrosis compared with abruption when thrombophilia is not diagnosed. These lesions suggest a chronic etiology of placental abruption in the presence of a maternal thrombophilia.
Volume
22
Issue
3
First Page
243
Last Page
248
ISSN
1476-4954
Published In/Presented At
Kinzler, W. L., Prasad, V., Ananth, C. V., & New Jersey-Placental Abruption Study Investigators (2009). The effect of maternal thrombophilia on placental abruption: Histologic correlates. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 22(3), 243–248. https://doi.org/10.1080/14767050802551795
Disciplines
Medicine and Health Sciences
PubMedID
19330709
Department(s)
Department of Obstetrics and Gynecology
Document Type
Article