Help Me Understand?

I lost my daughter in June due to PPROM at 18 weeks. They aren’t sure what caused it. I had to be induced because I was septic. Can anyone help me understand my placental results?

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FINAL PATHOLOGIC DIAGNOSIS:

Placenta:

Singleton placenta, 111.3 gm, 50% range for gestational

age.

Trivascular umbilical cord with urachal remnant and

ischemic changes.

Membranes with marked, Stage 2 acute chorioamnionitis.

Villous architecture appropriately immature for gestational

age with features of intrauterine fetal demise.

Intervillous hemorrhage.

--See Comment.

COMMENTS:

Acute chorioamnionitis is an important cause of preterm

labor and preterm deliveries, which in turn, are a

sig

nificant cause of perinatal morbidity and mortality.

The intervillous hematoma/thrombi (Kline's hemorrhages)

occur secondary to leakage from fetal capillaries, and the

possibility of a degree of fetomaternal hemorrhage cannot be

excluded, a Kleihauer-Betke test may be suggested.

CLINICAL HISTORY:

Preoperative Diagnosis: 18+3 weeks, septic.

Postoperative Diagnosis:

Symptoms/Radiologic Findings:

Procedure:

SPECIMENS:

Placenta

CODES:

88305

PROCEDURAL DEMOGRAPHICS:

Date of Procedure: 06/02/2018

Accession Date/Time: 06/04/2018 08:31

GROSS DESCRIPTION:

The specimen is received in formalin labeled with the

patient's name Paige Quakenbush, placenta. The specimen

consists of a singleton placenta measuring 9.5 x 8.5 x 3 cm

and weighs 111.3 grams. The disc appears intact. The

umbilical cord inserts eccentrically. The cord measures 29

cm in length and up to 0.7 cm in diameter. On sectioning,

there displays three blood vessels. There are no lesions

identified g

rossly. The amniotic rupture site cannot be

determined. The membranes insert peripherally, are gray tan

to brown tan, focally shaggy, hemorrhagic with a piece of

yellow brown hemorrhagic fibrinous material attached to the

disc, possible membrane tissue measuring 12 x 6 x 1 cm. The

fetal surface is purple gray, displays evenly distributed

blood vessels containing clotted blood. There are no

lesions identified. The maternal surface is slightly

shaggy. Sectioning the cut surface is red tan and spongy.

There is focal yellow gray fibrous area at the periphery

that measures 1 cm in greatest dimension. No other lesions

are identified.

Representative sections are submitted in cassettes as

follows: 1=cord and membranes, 2=area of the fibrinous

material attached to the disc, 3 and 4=full thickness

sections, 5=sections from the fibrous area.

KA/slw