Multifocal Rounded Intraplacental Hematomas, Placental Abruption and Intrauterine Fetal Demise.

Background: Rounded intraplacental hematomas (RIH) have a distinct rounded hemorrhagic appearance located within the placental parenchyma. Hemorrhagic villous infarctions (infarcts that when sectioned have hemorrhagic centers) are probably older RIH. RIH have been associated with acute abruptions. Case report: We describe multiple RIHs and hemorrhagic villous infarctions in various stages of development that arose between 20 and 27 weeks gestation, demonstrated by ultrasound, that developed an acute abruption and fetal death. Conclusions: The findings of RIHs, hemorrhagic infarcts, and lesions in between support the evolution of hemorrhagic villous infarctions from RIHs. These lesions can arise in the second trimester, and can be detected by ultrasound. These multiple lesions in various stages of evolution suggest an ongoing rather than a discrete insult. [ABSTRACT FROM AUTHOR]