Early Path Medical Consultation Services

Early Path Medical Consultation Services
Pathology Services Working for Safer Pregnancies

Coagulation Related Pathology

Coagulation is a principal defense mechanism of organisms against invading microorganisms. It plays a central role in both the damage and repair stages of tissue or cell injury or death. Coagulopathy has been implicated in the pathogenesis of certain types of obstetric compromise, including antiphospholipid antibody-related death and preeclampsia. The potential targets for pathologic coagulation include the maternal vasculature, the basal plate, the intervillous space, the villous (syncytiotrophoblast) surface and the fetoplacental vascualture.

The deposition of a fibrinoid layer at the maternal-placental interface is a standard process of normal pregnancy. This layer of Nitabuch's fibrin is progressively laid down throughout gestation, leading to, at term, a smooth plane of cleavage for the delivery of the placenta. Fibrin/fibrinoid deposition in the basal plate has been proposed to be a by-product of maternal-placental immunologic interactions; increased basal plate coagulation has been identified in cases of pregnancy compromise believed to be of immunologic origin. Increased basal coagulation results in a thick band of basal plate fibrin/fibrinoid replacing the normal zone of extravillous cytotrophoblasts and may even extend to involve several layers of entrapped and necrotic basal villi. Chronic anchoring villitis can often be seen in the "surviving" villi, perched atop the pile of necrotic and fibrinoid material. As in the extraplacental membranes, this material may contribute to the "immune barrier," but may not be the barrier to maternal lymphocytes it appears to be at the extraplacental choriodecidual interface.

The uterine vascualture is particularly susceptible to thrombosis (because its endothelium is normally eroded and the basement membranes and decidual stromal collagen are normally exposed to circulating maternal platelets) for up to 24 weeks.

Coagulation Related Case Reports (coming soon)

DISCLAIMER: This communication is for educational purposes only and it is not to be used as a substitute for a consultation with your physician. Should you contact Dr. Salafia's office, any responses to you will be based on the information you provide and no attempt will be made to confirm or verify any such information, including any laboratory data you may submit. Questions regarding actual symptoms of illness or health conditions should be addressed to a local health care practitioner who can physically examine and take responsibility for your care throughout the course of your condition/illness, which Dr. Salafia, being a physician licensed to practice medicine only in the State of New York, cannot and will not do. You should NOT use this information to diagnose or treat a health problem; rather, you should consult a qualified health care provider who examines you in person and who is licensed to practice in the state where you are located.