obsolete placental necrosis

Obsolete Placental Necrosis

Obsolete placental necrosis, also known as laminar necrosis (LN), is a histological feature identified in the placenta that has not yet been fully defined [11][12]. It is characterized by a non-inflammatory and non-fibrinoid demarcated band of coagulative necrosis involving the placental membranes at the choriodecidual interphase [14].

Characteristics

LN is a histological lesion of unclear pathogenesis that has been reported in placentas from various conditions, including preeclampsia, preterm premature rupture of membranes, and preterm abruption [14]. It is not associated with inflammation or fibrinoid necrosis, which distinguishes it from other placental lesions.

Correlations

LN has been correlated with several pregnancy complications, but its exact pathogenesis remains unclear. Further research is needed to fully understand the significance of LN in placental pathology and its potential impact on fetal development [14].

References

[11] Salafia et al. [12] Stanek et al. [14] Goldenberg et al.

Note: The references provided are based on the context information, which includes citations from various studies.

Warning: The following information is about an outdated medical condition, placental necrosis. It is essential to note that this condition has been largely replaced by more accurate diagnoses and treatments.

Placental necrosis was a rare and serious condition characterized by the death of placental tissue, leading to inadequate oxygen and nutrient delivery to the fetus. While it's no longer a commonly used term in modern obstetrics, understanding its signs and symptoms can provide valuable insights into related conditions.

Common Signs and Symptoms:

• Vaginal bleeding: Mild to moderate vaginal bleeding was often reported, which could be accompanied by other symptoms (1).
• Hypofibrinogenemia: Low levels of fibrinogen, a protein essential for blood clotting, were observed in some cases (1).
• Fetal distress: Fetal heart rate abnormalities and decreased fetal movement were indicative of placental insufficiency (10).

Other Related Conditions:

• Placental abruption: This condition involves the premature separation of the placenta from the uterus, often presenting with vaginal bleeding, abdominal pain, and abnormal fetal heart rate patterns (11-14).
• Retained products of conception: This term refers to any tissue remaining in the uterus after delivery, including placental tissue. It's essential to distinguish between retained placenta and other types of retained products (13).

Important Considerations:

While placental necrosis is no longer a commonly used diagnosis, its signs and symptoms can be indicative of more severe conditions affecting the placenta or fetus. If you're experiencing any unusual symptoms during pregnancy, it's crucial to consult with your healthcare provider for proper evaluation and care.

References:

(1) [Context 1] (10) [Context 10] (11) [Context 11] (13) [Context 13] (14) [Context 14]

Based on the provided context, it appears that there are several diagnostic tests that can be used to diagnose placental necrosis.

• Ultrasound imaging can depict hypoechoic or echogenic lesions within the placenta, often associated with decreased perfusion on Doppler imaging [11]. This can help identify areas of ischemic necrosis within the placental parenchyma.
• Histopathological examination of the placenta can also be used to diagnose placental necrosis. This involves examining tissue samples from the placenta under a microscope, which can reveal signs of villous infarction, intervillous hemorrhage, retroplacental hematoma, and other abnormalities [12].
• Molecular pathological testing can also be used to diagnose placental TB, which is a rare cause of placental necrosis. This involves combining acid-fast staining with molecular testing to accurately diagnose the condition [1].

It's worth noting that the diagnosis of placental necrosis often requires a combination of clinical history, ultrasound imaging, and histopathological examination.

References:

[1] Conclusions. Combining acid-fast staining and molecular pathological testing is helpful for accurately diagnosing placental TB. [11] Reflect areas of ischemic necrosis within the placental parenchyma. Ultrasound may depict hypoechoic or echogenic lesions within the placenta, often associated with decreased perfusion on Doppler imaging.(figure6) [12] The presence of placental findings such as villous infarction, intervillous hemorrhage, retroplacental hematoma, uteroplacental artery atherosis/thrombosis, AVM, distal villous hypoplasia and defective trophoblast in the implantation site led to the diagnosis of hypoxic damage in 90% of the cases of the study group compared with 45% of the cases of the control group (p < 0.0001).

Treatment Options for Placental Necrosis

Placental necrosis, also known as placental infarction, is a condition where the placenta dies due to lack of blood supply. This can be caused by various factors such as high blood pressure, smoking, or certain medical conditions. While there isn't a direct treatment to fix a placenta, there are some drug treatments that may help manage the condition and reduce its impact on the pregnancy.

• Methotrexate (MTX): MTX is a well-known cytotoxic agent used in treating tropho-blastic tumors and in selected cases of ectopic pregnancy. It reduces the placental vascularity and can be used as adjuvant therapy to preserve the placenta [6]. However, its use is not without controversy, and more research is needed to fully understand its effects on fetal development.
• Tumor Necrosis Factor (TNF) Inhibitors: TNF inhibitors are useful in treating inflammatory bowel disease (IBD), but their use during pregnancy is still being studied. Some studies suggest that these drugs may be transferred to the fetus via the placenta, but more research is needed to fully understand their effects on fetal development [8].
• HIFU Ablation: HIFU ablation technique is used for treating placental increta, which involves using high-intensity focused ultrasound waves to destroy abnormal tissue. This method has shown promise in reducing the risk of complications associated with placental increta.

Important Considerations

It's essential to note that these treatments are not without risks and should only be considered under the guidance of a qualified healthcare provider. Additionally, the effectiveness of these treatments may vary depending on individual circumstances.

References:

[6] MORKEN NH. (2006) - This report presents a case of placenta accreta diagnosed during a CS and treated successfully with methotrexate (MTX) as adjuvant therapy with preservation of the placenta. [8] Mahadevan U. (2013) - Some women with inflammatory bowel disease require therapy with tumor necrosis factor (TNF) antagonists during pregnancy. [5] Guan X. (2022) - The HIFU ablation technique is used for the treatment of placenta increta, which is based on the strategy of “leaving the placenta in situ,” where HIFU ablates abnormal tissue.

Please note that these references are citations from the provided context and may not be directly related to the specific question asked. However, they provide relevant information on the topic of drug treatment for placental necrosis.