Download PDF
Semin Thromb Hemost 1998; 24(5): 497-501
DOI: 10.1055/s-2007-996046
Copyright © 1998 by Thieme Medical Publishers, Inc.

A Clinicopathological Aspect of Chorionic Villous Hemorrhage Leading to Formation of Intervillous Thrombosis

Hiroaki Soma, Yoshiaki Watanabe, Hiroyuki Osawa, Toshio Hata
  • Department of Obstetrics and Gynecology, Saitama Medical School, 38 Morohongo, Moroyama-cho, Irumagun, Saitama Prefecture 350-0451, Japan
The authors would like to dedicate this paper to the late Professor Birger Åstedt, expressing many thanks for his friendship over more than 20 years.
Further Information

Publication History

Publication Date:
06 February 2008 (online)

  PDF Download  Permissions and Reprints

Abstract

Recently it was reported that chorionic villous hemorrhage (CVH) had a significant association with retroplacental hemorrhage (RPH). In this study, to determine whether CVH has a correlation with RPH or intervillous thrombosis (IVT), placentas associated with CVH were clinico-histopathologically investigated and compared to those with IVT. Obstetric complications in 32 cases with CVH were compared with 258 cases with IVT. Placental abruption was significantly higher (18.7%) in the CVH group than in the IVT group (5.03%) and the incidences of intrauterine fetal death (IUFD) as well as intrauterine growth retardation (IUGR) were also significantly higher (18.7% and 9.37%) in the CVH group than in the IVT group (3.10% and 2.32%). Of the pathological characteristics of the placentas with CVH, IVT was found in 46.8%, but marginal or retroplacental hemorrhages were seen in 34.3%, compared to 14.2% of the IVT group.

Premature infants with low birth weight (under 2000 g) and before 36 weeks of gestation were born in 53.1% and 34.3% of cases with CVH placentas.

CVH was not only located near the basal plate of the placentas and decidual hemorrhages, but was also highly associated with chorangiosis in 75% of cases.

Using histological and ultrastructural studies in CVH cases, villous stroma was filled with fetal erythrocytes and leakage of blood cells was observed through a disruption of the trophoblast layer of hemorrhagic villi. In conclusion, it is suggested that CVH may rather be related to formation of the intervillous thrombosis than to RPH.

Keywords:

Intervillous thrombosis - chorangiosis - chorionic villous hemorrhage - placental abruption - feto-maternal blood mixture