PLACENTAL POLYP (polypus placentarius; lat. placenta, from grech, plakus flat cake; a polyp) — the organized remains of chorion or a placenta densely attached to a wall of a uterus.
Sites of chorion can remain in a uterus during incomplete removal of fetal egg during abortion. The delay in a uterus of parts of a placenta after the delivery is a consequence of the wrong maintaining the afterbirth period or pathology of an attachment or structure placentae (see).
While vorsina of chorion are in a uterus, its walls bleed, the emitted blood turns, on the periphery fibrin is deposited, in the center there are vorsina, to-rye are exposed to a necrosis, a hyalinosis and obyzvestvlyatsya gradually.
Macroscopically Pct — formation of a plotnoelastichesky consistence of dark red or brown color. The size of Pct fluctuates from several millimeters to 5 — 6 cm, in rare instances reaches 10 — 15 cm. Microscopically vorsina of chorion are deprived of a syncytial cover, nekrotizirovana, a stroma of their gialinpzirovan, vorsina are surrounded with fibrin (tsvetn. fig. 24).
The basic the wedge, a symptom of Pct is bleeding (see. Hypotonic bleedings ). At P. P. which arose after abortion, severe bleeding begins suddenly, hl. obr. in days, the corresponding periods. At the Pct which arose after the delivery severe bleeding arises on 3 — 5th week of a puerperal period. At vaginal examonation define a little increased and softened uterus, formation of a neck of uterus is absent. During the research scanty bloody allocations often appear. Sometimes the uterus is not increased, but dense, strained as a result of strong reduction. Repeated bleedings lead to anemia. The parts of chorion or a placenta which remained in a uterus are the favorable environment for the microorganisms causing an inflammation of an endometria (see. Metroendometritis ). From the remains of a chorial epithelium development of a malignant tumor — a horionepitelioma is possible (see. Trophoblastic disease ).
Diagnosis put on the basis of data of the anamnesis and a wedge, pictures, and also gistol, researches of the material received at diagnostic scraping (see).
Treatment operational — is carried out by a scraping of a mucous membrane of a uterus and removal of a polyp. At signs of an inflammation and absence of plentiful bleeding prepost antiinflammatory treatment. For the purpose of prevention of the subsequent infection or an aggravation of inflammatory process after a scraping within 2 — 3 days appoint the antibiotics and means reducing a uterus.
Forecast in most cases favorable. It worsens at development of a horionepitelioma.
Prevention consists in the correct maintaining afterbirth period (see), careful survey of a placenta after its birth. In doubtful cases conduct manual examination of a cavity of the uterus and removal of the late pieces of a placenta. At abortion full removal of elements of fetal egg is necessary.
Bibliography: Alimova of X. P. The closest and remote effects of artificial abortions, in book: Aktualn, vopr, akush. and ginek., under the editorship of A. A. Kadyrova, century 1, page 71, Tashkent, 1976; Swan B. W. a. Woodruff J.D. Retained products of conception, Obstet. and Gynec, v. 34, p. 506, 1969.
K. A. Kurysheva.