Involution

  • Kurt Benirschke
  • Peter Kaufmann

Abstract

Pathologists rarely obtain a postpartum uterus for detailed study of involutional changes that take place at the former site of implantation. Therefore involution of the normal placental site has been studied by only a few investigators. Normally, the postpartum lochia contain the decidual remnants, including perhaps the remains of the vasculature that had previously undergone the “physiological changes” of pregnancy. Only when significant postpartum hemorrhage occurs and hysterectomy becomes necessary is the pathologist asked to seek the cause of the bleeding. He or she may then find remains of villi, incompletely thrombosed vessels, “placental polyps,” and inflammatory reaction. These areas are difficult to study objectively, because most pathologists have no experience with the normal, complex process of placental site involution. Williams (1931), in a classical paper, attempted to rectify this situation.

Keywords

Placental Tissue Postpartum Hemorrhage Implantation Site Placenta Accretas Puerperal Fever 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anderson, W.R., and Davis, J.: Placental site involution. Am. J. Obstet. Gynecol. 102:23–33, 1968.PubMedGoogle Scholar
  2. Bronson, R., Volk, T.L., and Ruebner, B.H.: Involution of placental site and corpus luteum in the monkey. Am. J. Obstet. Gynecol. 113:70–75, 1972.PubMedGoogle Scholar
  3. Dyer, I., and Bradburn, D.M.: An inquiry into the etiology of placental polyps. Am. J. Obstet. Gynecol. 109: 858–867, 1971.PubMedGoogle Scholar
  4. Friedländer, C.: Physiologisch-anatomische Untersuchungen über den Uterus. Simmel and Co., Leipzig, 1870.Google Scholar
  5. Hoberman, L.K., Hawkinson, J.A., and Beecham, C.T.: Placental polyp: report of 3 cases. Obstet. Gynecol. 22:25–29, 1963.PubMedGoogle Scholar
  6. Lanman, J.T., Mitsudo, S.M., Brinson, A.O., and Thau, R.B.: Fetectomy in monkeys (Macaca mulatta); retention of the placenta past term. Biol. Reprod. 12:522–525, 1975.PubMedCrossRefGoogle Scholar
  7. Lawrence, W.D., Qureshi, F., and Bonakdar, M.I.: “Placental polyp”: light microscopic and immunohisto-chemical observations. Hum. Pathol. 19:1467 – 1470, 1988.PubMedCrossRefGoogle Scholar
  8. Lewis, J., and Hertz, R.: Effects of early embryectomy and hormonal therapy on the fate of the placenta in pregnant rhesus monkeys. Proc. Soc. Exp. Biol. Med. 123:805–809, 1966.PubMedCrossRefGoogle Scholar
  9. Ludwig, H.: Surface structure of the human term placenta and of the uterine wall post partum in the screen scan electron microscope. Am. J. Obstet. Gynecol. 111:328–344, 1971.PubMedGoogle Scholar
  10. Ludwig, H., and Metzger, H.: Das uterine Placentarbett post partum im Rasterelektronenmikroskop, zugleich ein Beitrag der extravasalen Fibrinbildung. Arch. Gynäkol. 210:251–266, 1971.PubMedCrossRefGoogle Scholar
  11. Mäher, J.A.: Morphologie and histochemical changes in postpartum uterine blood vessels. A.M.A. Arch. Pathol. 67:175–180, 1959.Google Scholar
  12. Mukaida, T., Yoshida, K., and Soma, H.: A surface ultrastructural study of the placental separation site. J. Clin. Electron Microsc. 8:5–6, 1975.Google Scholar
  13. Myers, R.E., and Panigel, M.: Experimental placental detachment in the rhesus monkey: Changes in villous ultrastructure. J. Med. Primatol. 2:170–189, 1973.PubMedGoogle Scholar
  14. Panigel, M., and Myers, R.E.: Histological and ultra-structural changes in rhesus monkey placenta following interruption of fetal placental circulation by fetectomy or interplacental umbilical vessel ligation. Acta Anat. (Basel) 81:481–506, 1972.Google Scholar
  15. Philippe, E., Ritter, J., Renaud, R., Dellenbach, P., Fonck-Cussac, Y., andGandar, R.: Les métrorrhagies tardives du post-partum par anomalie d’involution des artères utéro-placentaires. Rev. Fr. Gynécol. 63:255–262, 1968.Google Scholar
  16. Rutherford, R.N., and Hertig, A.T.: Noninvolution of the placental site. Am. J. Obstet. Gynecol. 49:378–384, 1945.Google Scholar
  17. Schneider, L.: Über Vorkommen und Bedeutung leu-kocytärer Infiltrate im Ablösungsbereich der spontangeborenen Placenta. Arch. Gynäkol. 208:247–254, 1970.PubMedCrossRefGoogle Scholar
  18. Sharman, A.: Post-partum regeneration of the human endometrium. J. Anat. 87:1–10, 1953.PubMedGoogle Scholar
  19. Stamm, H.: Alte und neue Probleme bei Plazentarpolypen. Gynaecologia 151:252–260, 1961.Google Scholar
  20. Thorsteinsson, V.T., and Kempers, R.D.: Delayed postpartum bleeding. Am. J. Obstet. Gynecol. 107:565–571, 1970.PubMedGoogle Scholar
  21. van Wagenen, G., and Newton, W.H.: Pregnancy in the monkey after removal of the fetus. Surg. Gynecol. Obstet. 77:539–549, 1943.Google Scholar
  22. Walsh, S.Z.: Maternal effects of early and late clamping of the umbilical cord. Lancet 1:996–997, 1968.PubMedCrossRefGoogle Scholar
  23. Williams, J.W.: Regeneration of the uterine mucosa after delivery, with especial reference to the placental site. Am. J. Obstet. Gynecol. 22:664–696, 793–796, 1931.Google Scholar
  24. Young, R.H., Kurman, R.J., and Scully, R.E.: Placental site nodule. Mod. Pathol. 1:107A, 1988.Google Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Kurt Benirschke
    • 1
    • 2
  • Peter Kaufmann
    • 3
  1. 1.Pathology and Reproductive MedicineUniversity of CaliforniaSan DiegoUSA
  2. 2.University Medical CenterSan DiegoUSA
  3. 3.Institut für Anatomie der Medizinischen Fakultät, Rheinisch-Westfälische TechnischeHochschule AachenAachenGermany

Personalised recommendations