Asymptomatické akutní masivní odloučení placenty v 30. týdnu těhotenství u primigravidy bez rizikových faktoru – klinické projevy a léčba

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Authors: Paolo Meloni ¹; Terenzia Simari ²; Rodolfo Brizio ³; Roberto Conturso ⁴; Ilenia Mappa ⁵; Giuseppe Rizzo ⁵; Edward Araujo Júnior ⁶; Gabriele Tonni ⁷
Authors‘ workplace: Department of Obstetrics and Gynecology, ASL1 Imperiese, Imperia, Liguria, Italy ¹; Antenatal Clinic, ASL1 Imperiese, Imperia, Liguria, Italy ²; Human Pathology Service, ASL1 Imperiese, Imperia, Liguria, Italy ³; Prenatal Medicine, Sant’Anna Hospital, Lugano, Switzerland ⁴; Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy ⁵; Department of Obstetrics, Paulista School of Medicine – Federal University of S’ao Paulo (EPM-UNIFESP), São Paulo, Brazil ⁶; Prenatal Dia gnostic Service, Department of Obstetrics and Neonatology, and Researcher, Istituto di Ricovero e Cura a Carattere Scientifi co, (IRCCS), AUSL Reggio Emilia, Reggio Emilia, Italy ⁷
Published in: Ceska Gynekol 2024; 89(3): 215-218
Category: Case Report
doi: https://doi.org/10.48095/cccg2024215

Overview

Odloučení placenty může být katastrofální událostí s následky pro matku i plod. Prezentujeme masivní odloučení placenty, ke kterému došlo u mladé asymptomatické matky v 30. týdnu těhotenství. Ačkoli elektronický monitoring plodu a ultrazvuk umožnily rychlou diagnózu retroplacentárního hematomu o velikosti 8 × 5 cm, plod během akutního císařského řezu odumřel. Plod byl intubován a resuscitován, ale neúspěšně. Histologické vyšetření placenty prokázalo ztenčené a na sebe navrstvené choriové klky se zvýšeným množstvím kapilár a syncitiálními hnízdy a ložisky fibrinoidní nekrózy za přítomnosti hyalinních pruhů jak na straně matky, tak na straně plodu.

Klíčová slova:

histopatologické vyšetření – odloučená placenta – bez rizikových faktorů – akutní distres plodu – akutní císařský řez

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ORCID authors

P. Meloni 0000-0003-2775-3216

T. Simari 0009-0000-4474-7569

R. Brizio 0000-0003-2979-1531

R. Conturso 0009-0000-8980-0212

I. Mappa 0000-0002-9866-3050

G. Rizzo 0000-0002-5525-4353

E. Araujo Júnior 0000-0002-6145-2532

G. Tonni 0000-0020-7486-2620

Submitted/Doručeno: 18. 9. 2023

Accepted/Přijato: 16. 2. 2024

Prof. Edward Araujo Júnior, MD, PhD