Chronic peripheral separation of placenta - The significance of diffuse chorioamnionic hemosiderosis

Diffuse nonmeconium-related pigment was observed in the chorioamnion of 36 of 1, 023 placentas over 4 years and evaluated by iron staining Stains were negative in 13 cases and positive in chorionic plate and membranes (diffus e chorioamnionic hemosiderosis [DCH]) in 23 cases (3/1,000 deliveries; 25/1 ,000 placentas). Gestational age at delivery tvas lower in DCH and was inve rsely proportional to the magnitude of iron staining. Placentas with DCH we re more likely to show circumvallation, old peripheral blood clots, increas ed chorionic-villous macrophages, and green discoloration. To evaluate demo graphic, obstetric, and perinatal factors associated with DCH, 2 gestationa l age-matched controls were selected for each DCH case. Multiparity, smokin g, and chronic vaginal bleeding all were increased significantly with DCH, while intrauterine growth retardation and oligohydramnios were increased bu t did not achieve statistical significance Gestational hypertension and adv anced maternal age were significantly decreased with DCH, and cocaine abuse was uncommon (3 cases). Long-term neurologic sequelae of DCH were evaluate d in a separate series of gestational age-matched very-low-birth-weight inf ants with and without neurologic impairment at 2 years of age. No increased risk of neurologic impairment was found in patients with DCH.