Rupture of the Marginal Sinus of the Placenta

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Abstract
"Abscission windows" open from the basal plate of the marginal sinus of the placenta[long dash]a natural result of separation of the placenta. The circular or marginal sinus, the chief pathway of return of maternal blood within the human placenta, is drained by numerous wide and short, communicating venous channels through the decidua basalis, into an underlying venous plexus of the uterine wall. During separation, truncation of these communicating channels in the spongiosa of the decidua basalis, leaves vessel segments which are so short as to be mere ostia through the basal plate of the marginal sinus[long dash]i.e., abscission windows through the otherwise continuous and intact basal plate of the marginal sinus of the separated placenta. "Rupture of the marginal sinus", by abscission window formation without laceration, is the most common cause of external uterine bleeding during late pregnancy. True laceration, by circumferential avulsion of the basal plate from its junction with the chorionic plate, and rarely, radial laceration of the basal plate of the marginal sinus do occur. The chief importance clinically, is to distinguish the benign bleeding of marginal sinus rupture, not only from the simple, painless hemorrhaging of definitive placenta previa, but from the painful hematoma of abruptio placenta. Abruptio placentae may present hazards of fibrination-defibrination, in which coagulation of the circulating blood itself, is caused by tissue-thromboplastin from the decidua.
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