title: Is pathologic confirmation of placental abruption more reliable in cases due to chronic etiologies compared with acute etiologies?
abstract: BACKGROUND
  Pathology laboratories often receive requests for confirmation of abruption; however, pathologically, abruption can only be confirmed by the presence of adherent blood clot on the maternal surface that is indenting the underlying placental parenchyma.
  
  
  METHODS
  We evaluated whether abruptions due to more chronic underlying medical conditions are more likely to have a retained indenting retroplacental clot that is detectable by the pathologist than abruptions due to acute etiologies. This was a retrospective review from January 1995 to June 2012 of cases with a clinical and/or pathologic diagnosis of abruption. Data were analyzed utilizing Fisher's exact test.
  
  
  RESULTS
  Ninety-six cases had sufficient available information for analysis. There was a significant association between pathologic identification of abruption and chronic risk factors (P=0.03). Twenty-five percent of cases with acute risk factors and 60% of cases with chronic risk factors had abruption confirmed at pathologic evaluation (P=0.12).
  
  
  CONCLUSIONS
  Pathologically confirmable abruption is associated with chronic risk factors. There was a trend towards chronic risk factors leading to greater likelihood of pathologic confirmation of abruption than acute risk factors, but it did not reach statistical significance.
authors.forename: Debra S
authors.initials: DS
authors.lastname: Heller
authors.forename: Megan
authors.initials: M
authors.lastname: Keane-Tarchichi
authors.forename: Shalini
authors.initials: S
authors.lastname: Varshney
mesh_terms: D000037:Abruptio Placentae / Q000209:etiology* / Q000473:pathology*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002821:Chorioamnionitis; D002908:Chronic Disease; D019970:Cocaine-Related Disorders / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D010920:Placenta / Q000473:pathology; D011225:Pre-Eclampsia; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications