Placental polyp: a diagnostic dilemma

Authors

  • Sravani Chithra. Ch Department of Gynaecology Endoscopy Unit, Manchanda's Endoscopic Centre, PSRI Hospital, Delhi, India
  • Rahul Manchanda Department of Gynaecology Endoscopy Unit, Manchanda's Endoscopic Centre, PSRI Hospital, Delhi, India
  • Anshika Lekhi Department of Gynaecology Endoscopy Unit, Manchanda's Endoscopic Centre, PSRI Hospital, Delhi, India
  • Nidhi Jain Department of Gynaecology Endoscopy Unit, Manchanda's Endoscopic Centre, PSRI Hospital, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20162078

Keywords:

Curettage, Placental polyp, Histopathology, Hysteroscopy, Ultrasound

Abstract

Placental polyp is the retained fragment of placental tissue after parturition or abortion for indefinite period which forms a polypoidal mass in the uterus. It has an incidence of less than 0.25% of all pregnancies. It is predominantly composed of necrotic and hyalinized chorionic villi. These pedunculated masses present within days to weeks following an abortion or delivery of a term placenta. The patient presents with abnormal uterine bleeding and slightly elevated detectable titers of serum β-human chorionic gonadotropin (βHCG). Here we have reviewed the literature of placental polyp regarding its pathogenesis, diagnosis and management. The authors would like to stress the importance of hysteroscopy in diagnosis and management of placental polyp that can be missed on ultrasound and blind procedure like curettage and histopathology that gives a confirmatory diagnosis.

References

Watcharotone W, Leelaphatanadit C. Placental polyp: a case report. Siriraj Med J. 2005;57:391-2.

Kaneko M, Harima H, Okagaki R, Hosoya I, Shigemitsu S, Kasahara K, et al. A case of placental polyp developed immediately after spontaneous abortion. Nippon Sanka Fujinka Gakkai Zasshi. 1992;44:255-7.

Palat P, Suma S, Kantarcy M, Alper F, Levent A. Colour doppler US in the evaluation of uterine vascular abnormalities. Radio Graphics. 2002;22:47-53.

Milovanov AP, Kirsanov IN. The pathogenesis of uterine hemorrhages in the so-called placental polyps. Arkh Patol. 2008;70:34-7.

Baer BF. Placental polypus which simulated malignant disease of the uterus. Philadelphia Med Times. 1884;15:175.

Dorsey CW. Placental polyp with severe late puerperal hemorrhage. Am J Obst and Gynec. 1942;44:591.

Hagstorm HT. late puerperal hemorrhage due to placental polyp. Am J Obst and Gynec. 1940;39:879.

Hoberman LK, Hawkinson JA, Beecham CT. Placental polyp: report of 3 cases. Obstet Gynecol. 1963;22:25-9.

Ranney B. Relative atony of myometrium underlying the placental site secondary to high corneal implantation, a major cause of retained placentas. Amer J Obstet Gynec. 1956;71:1049.

Eastman N, Hellman LM. Williams obstetrics. Appleton New York; 1966.

Yi JG, Choi SE, Shin YK, Lee JH. Placental polyp: Sonographic findings. Am J Radiol. 1993;161:345-6.

Swan RW, Woodruff JD. Retained products of conception. Histologic viability of placental polyps. Obstet Gynecol. 1969;34:506-14.

Shanthi V, Rao NM, Lavanya G, Krishna BR, Mohan KM. Placental polyp-a rare case report. Turk Patoloji Derg. 2015;31:77-9.

Van den Bosch T, Daemen A, Van Schoubroeck D, Pochet N, De Moor B, Timmerman D. Occurrence and outcome of residual trophoblastic tissue: a prospective study. J Ultrasound Med. 2008;27(3):357-61.

Hiraki K, Khan KN, Kitajima M, Fujishita A, Masuzaki H. Uterine preservation surgery for placental polyp. J Obstet Gynaecol Res. 2014;40(1): 89-95.

Kurachi H, Maeda T, Murakami T, Tsuda K, Sakata M, Nakamura H, et al. MRI of placental polyps. J Comput Assist Tomogr. 1995;19:444-8.

Takeda A, Koyama K, Imoto S, Mori M, Sakai K, Nakamura H. Placental polyp with prominent neovascularization. Fertil Steril. 2010;93:1324-6.

Takeda A, Koyama K, Imoto S, Mori M, Sakai K, Nakamura H. Computed tomographic angiography in diagnosis and management of placental polyp with neovascularization. Arch Gynecol Obstet. 2010;281:823-8.

Umezu T, Iwase A, Ota T, Suzuki K, Nakagawa A, Nakahara T, et al. Three dimensional CT angiography is useful for diagnosis of postabortion uterine hemorrhage: 3 case reports and review of the literature. J Minim Invasive Gynecol. 2010;17:246-51.

Takeuchi K, Ichimura H, Masuda Y, Yamada T, Nakago S, Maruo T. Selective trans-arterial embolization and hysteroscopic removal of a placental polyp with preservation of reproductive capacity. J Reprod Med. 2002;47:608-10.

Takeuchi K, Sugimoto M, Kitao K, Yoshida S, Maruo T. Pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp. Acta Obstet Gynecol Scand. 2007;86:22-5.

Dyer I, Bradburn DM. An inquiry into the etiology of placental polyps. Am J Obstet Gynecol. 1971;109:858-67.

Jimenez JS, Gonzalez C, Alvarez C, Munoz L, Perez C, Munoz JL. Conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy. Eur J Obstet Gtnecol Reprod Biol. 2009;145:89-92.

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Published

2017-02-23

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Review Articles