Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 5 ( September-October, 2021 ) > List of Articles

RESEARCH ARTICLE

Endometrial Histopathological Evaluation in Antepartum Hemorrhage for Placental Etiology

Sarbeswar Mandal, Chaitali Karmakar, Masihon Murmu, Nurejjaman, Mahua Mondal, Shermin Siria Begum

Keywords : APH, Decreased fibrin deposition, Endomyometrial biopsy, Hemorrhage, Less physiological changes, Trophoblast invasion

Citation Information : Mandal S, Karmakar C, Murmu M, N, Mondal M, Begum SS. Endometrial Histopathological Evaluation in Antepartum Hemorrhage for Placental Etiology. J South Asian Feder Obs Gynae 2021; 13 (5):319-324.

DOI: 10.5005/jp-journals-10006-1954

License: CC BY-NC 4.0

Published Online: 22-12-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aims and objectives: The aims of the study were to investigate and identify the structural changes in endomyometrium in association with placental causes of antepartum hemorrhage (APH). Background: The microscopic comparative evaluation of endomyometrium in upper and lower segments including placental bed in APH and non-APH. Type of study: This is a clinical, interventional, prospective, randomized controlled trial (RCT). Place, duration, and sample size: The study was conducted in the Department of Gynaecology and Obstetrics, IPGMER-SSKM Hospital, Kolkata, West Bengal, India, prior to more than a year. Methods and materials: After getting ethical approval, sixty-four (64 cases) APH and non-APH patients were selected, randomized, and allowed into two groups for management point of view by cesarean delivery like Gr-A (N = 32) = cases (APH); Gr-B (N = 32) = controls (non-APH). Four samples from each patient during cesarean delivery of randomly selected cases and controls each from upper lower, anterior, and posterior with one must from placental bed were taken and studied microscopically. The results of microscopic features revealed that there were hemorrhage, an unusual, abnormal vascular structure, absent deciduas changes, direct contact between placenta and myometrium with higher trophoblast infiltration into deciduas, myometrium, and vessels with decreased villous fibrin deposition. Conclusion: The decidua has a major role to play in negotiating “the treaty of compromise” ultimately signed between fetal and maternal tissues if such a treaty is not signed or broken, defective placentation (imperfect fibrinoid—Nitabuch layer) and its consequence must follow.


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