The number of multinucleated trophoblastic giant cells in the basal decidua is decreased in retained placenta

H J van Beekhuizen, I Joosten, A N J A de Groot, F K Lotgering, J van der Laak, J Bulten
2009 Journal of Clinical Pathology  
airpost.n et A cce pted 5 M a ABSTRACT Aim s: Retained placenta (RP) is a major cause of obstetric haemorrhage. The aim of the study was to obtain a better understanding of the mechanisms that cause some placentas to become retained, while most are not. M ethods: 23 RPs clinically diagnosed as placenta adhesiva and 10 control placentas (CPs) were examined for differences in trophoblast fusion into multinucleated trophoblastic giant cells (MTGCs), defects in the basal decidua, and decidual
more » ... and decidual attachment of myometrial fibres. Results: The number of MTGCs in the basal decidua was significantly smaller in RPs (0.23 MTGC/standard length) than in CPs (1.11 MTGC/standard length) (p<0.001). Defects in the decidua were observed in 4% of the RPs and in 0% of the CPs. Myometrial fibres were attached to the decidua in 78% of the RPs and in 0% of the CPs (p<0.001). Conclusions: In placenta adhesiva compared with CPs, significantly less MTGCs were present in the basal decidua, the basal decidua was intact, and myometrial fibres were more frequently attached to the basal decidua. It is speculated that these findings may indicate that defective fusion of trophoblastic cells into MTGCs plays a causative role in placenta adhesiva.
doi:10.1136/jcp.2009.065953 pmid:19734475 fatcat:ogmek3kqanbdpiutzeysu34oym