The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.
Diagnosis of placental abruption: relationship between clinical and histopathological findings
Open accessAbstract
Objective We evaluated the extent to which histologic lesions bearing a diagnosis of abruption conform to a diagnosis based on established clinical criteria. We further examined the profile of chronic and acute histologic lesions associated with clinical abruption.Methods Data from the New Jersey-Placental Abruption Study - a multi-center, case-control study - were utilized to compare the clinical and histologic criteria for abruption. The study was based on 162 women with clinically diagnosed abruption and 173 controls. We examined the concordance between clinical indicators for abruption with those of a histopathological diagnosis. The clinical criteria for a diagnosis of abruption included (i) evidence of retroplacental clot(s); (ii) abruption diagnosed on prenatal ultrasound; or (iii) vaginal bleeding accompanied by nonreassuring fetal status or uterine hypertonicity. The pathological criteria for abruption diagnosis included hematoma, fibrin deposition, compressed villi, and hemosiderin-laden histiocytes in cases with older hematomas. Acute lesions included chorioamnionitis, funisitis, acute deciduitis, meconium stained membranes, villous stromal hemorrhage, and villous edema. Chronic lesions included chronic deciduitis, decidual necrosis, decidual vasculopathy, placental infarctions, villous mal-development (delayed or accelerated maturation), hemosiderin deposition, intervillous thrombus, and chronic villitis.Results Of clinically diagnosed cases, the sensitivity and specificity for a histologic confirmation of abruption were 30.2% and 100%, respectively. Presence of retroplacental clots remained the single most common finding (77.1%) among clinically diagnosed cases. Among the acute lesions, chorioamnionitis and funisitis were associated with abruption. The only chronic histologic lesion associated with abruption was placental infarctions.Conclusions The concordance between clinical and pathologic criteria for abruption diagnosis is poor. The criteria for diagnosing a clinical abruption should include sonographic visualization of abruption, evidence of retroplacental clots, or vaginal bleeding accompanied by nonreassuring fetal status or uterine hypertonicity.
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“Ultrasound may identify findings concerning for abruption, especially when abnormal blood collections adjacent to and within the placenta are large (FIGURE 3–5) (50).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [50]
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“The amount of vaginal bleeding, which may be difficult to quantify due to concealed bleeding, does not correlate with clinical sequelae (50).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [50]
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Cites
The Pathology of the Human Placenta
Benirschke, K., & Driscoll, S. G. (1967) · Springer eBooks · doi:10.1007/978-1-4612-9809-0 · Cited by 2,253
Maternal-Fetal Medicine: Principles and Practice
Welch, R. A. (1985) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1985.02140060022017 · Cited by 928
Oyelese, Y., & Ananth, C. V. (2006) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000239439.04364.9a · Cited by 508
Self-citationPlacental abruption and adverse perinatal outcomes
Ananth, C. V. (1999) · JAMA · doi:10.1001/jama.282.17.1646 · Cited by 412
Self-citationPlacental abruption and perinatal mortality in the United States
Ananth, C. V., & Wilcox, A. J. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.4.332 · Cited by 311
Self-citationSalafia, C. M., MINIOR, V. K., Pezzullo, J. C., Popek, E. J., Rosenkrantz, T. S., & Vintzileos, A. M. (1995) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(95)91325-4 · Cited by 308
Self-citationANANTH, C., SAVITZ, D., & WILLIAMS, M. (1996) · Obstetrics & Gynecology · doi:10.1016/0029-7844(96)00088-9 · Cited by 236
Self-citationEtiologic determinants of abruptio placentae
KRAMER, M., USHER, R., POLLACK, R., BOYD, M., & USHER, S. (1997) · Obstetrics & Gynecology · doi:10.1016/s0029-7844(96)00478-4 · Cited by 212
Ananth, C. V., Oyelese, Y., Srinivas, N., Yeo, L., & Vintzileos, A. M. (2004) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000128172.71408.a0 · Cited by 208
Pathology of the Human Placenta
Bergsjø, P. (2001) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/j.1600-0412.2001.800721-2.x · Cited by 208
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Grantz, K. L., Shenassa, E. D., & Downes, K. L. (2017) · American Journal of Perinatology · doi:10.1055/s-0037-1599149 · Cited by 168
Hypoxic Patterns of Placental Injury: A Review
Stanek, J. W. (2013) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2011-0645-ra · Cited by 141
An international contrast of rates of placental abruption: an age-period-cohort analysis
Ananth, C. V., Keyes, K. M., Hamilton, A., Gissler, M., Wu, C., Liu, S., Luque-Fernandez, M. A., Skjærven, R., Williams, M. A., Tikkanen, M., et al. (2015) · PLoS ONE · doi:10.1371/journal.pone.0125246 · Cited by 131
Self-citationAnanth, C. V., & VanderWeele, T. J. (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwr045 · Cited by 123
Self-citationBrandt, J. S., & Ananth, C. V. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.06.059 · Cited by 115
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Metadata
- Authors
- Elsasser, D. A., Ananth, C. V., Prasad, V., & Vintzileos, A. M.
- Affiliations
- Nationwide Children's Hospital (US)
- Winthrop-University Hospital (US)
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2010-02
- Volume
- 148
- Issue
- 2
- Pages
- 125-130
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- PMC
- PMC2814948
- OpenAlex
- W1966530833
- Cited by
- 151
- References
- 38
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 8 · 2023: 11 · 2022: 15 · 2021: 14 · 2020: 8 · 2019: 12 · 2018: 9 · 2017: 8 · 2016: 9 · 2015: 10 · 2014: 6 · 2013: 9 · 2012: 7
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD038902)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- placental abruption, diagnosis, histopathological diagnosis, diagnostic agreement, chorioamnionitis, funisitis, placental infarction, decidual vasculopathy, chronic villitis, sensitivity and specificity
- MeSH terms
- Abruptio Placentae, Adult, Female, Humans, Placenta, Pregnancy, Case-Control Studies, Young Adult
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