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Obstet Gynecol. 1979 May;53(5):583-6.

Placental histopathology of midtrimester termination.


Placentas spontaneously passed after second-trimester terminations of pregnancy using either hypertonic sodium chloride or hyperosmolar urea plus prostaglandin F2alpha (PGF2alpha) were examined to determine histologic characteristics. The placentas of hypertonic sodium chloride terminations demonstrated a type of "coagulation necrosis" that has been described previously, while placentas of pregnancies terminated by hyperosmolar urea plus PGF2alpha showed a similar pattern in about one half the cases but a histologic pattern of less severe damage in the remaining cases. The 2 groups showed no significant differences when characteristics such as injection-abortion interval or estimated hypertonicity of the fluid were examined.


Second trimester placentas, passed spontaneously in 17 abortions induced by hypertonic sodium chloride and in 45 abortions induced by hyperosmolar urea plus prostaglandin F, were histologically compared; in 16 of the 17 sodium chloride cases, a pattern of severe tissue damage (Type A) was observed, and in the urea cases, approximately half of the cases exhibited Type A damage and the other half had a less severe form of damage (Type B). Type A damage is characterized by a zone of "coagulation necrosis" in which cell structure is lost, vessels are thrombosed, and there is severe inflammation. In Type B damage, cell structure is maintained, vessels are not thrombosed, and inflammation is diffuse. In previous studies of sodium chloride induced abortions, Type A damage had been noted and attributed to the hypertonicity of the abortifacient agent. Since half of the urea cases also had Type A damage, an attempt was made to discover clinical differences between the Type A and Type B urea cases. No significant differences were found; however, a scatter diagram suggests that patients with high concentrations of urea and with a longer interval between injection and subsequent abortion tended to exhibit Type A damage, while those with a shorter interval between injection and abortion manifested Type B damage. Tables include clinical characteristics of age, parity, duration of gestation, injection abortion interval, and amount of amniotic fluid removed for urea cases and a scatter diagram depicting interval time and estimated urea concentration. Photographs of tissue sections depicting Type and Type B damage are also included.

[Indexed for MEDLINE]

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