Placental mesenchymal dysplasia, a case of intrauterine sudden death

Placental mesenchymal dysplasia (PMD) is a rare condition presenting with enlarged, multicystic placenta like molar changes. Although PMD usually features a normal fetus and the pregnancy often extends into the third trimester, PMD is clinically significant lesion with high rates of FGR, IUFD, and i...

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Bibliographic Details
Published in:Kobe journal of the medical sciences 2014, Vol.60 (1), p.E1-E4
Main Authors: Yamada, Ai, Sakaida, Noriko, Okamura, Akiharu, Yamada, Takashi, Ota, Takehito, Bo, Masaki
Format: Article
Language:English
Subjects:
Adult
Chorionic Villi - abnormalities
Chorionic Villi - blood supply
Female
Gestational Age
Humans
Mesoderm - abnormalities
Mesoderm - diagnostic imaging
Perinatal Death - etiology
Placenta - abnormalities
Placenta - blood supply
Placenta - diagnostic imaging
Pregnancy
Rupture, Spontaneous
Ultrasonography, Prenatal
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Summary:Placental mesenchymal dysplasia (PMD) is a rare condition presenting with enlarged, multicystic placenta like molar changes. Although PMD usually features a normal fetus and the pregnancy often extends into the third trimester, PMD is clinically significant lesion with high rates of FGR, IUFD, and is associated with Beckwith-Wiedemann syndrome (BWS). We report a 30-year old woman at her first pregnancy with intrauterine sudden death at 31 weeks of gestation. The vesicular lesion in her uterus was detected at 10 weeks on ultrasound. The fetus was normal size without any anomaly on ultrasound and normal trophoblastic vascularization by Doppler study during the pregnancy. As the pregnancy advanced, the vesicular lesion decreased in size and no fetal abnormalities were detected. At 28 weeks of gestation an ultrasound detected dilated periumbilical chorionic vessels. We didn't detect severe FGR or abnormal trophoblastic vascularization. At 31 weeks of gestation an intrauterine sudden death of a normal-sized fetus without any anomaly occurred. The placenta was enlarged, and microscopic morphology confirmed a diagnosis of PMD. The chorionic vessels were cirsoid, dilated and tortuous. We determined the rupture of expanded periumbilical chorionic vessels led to fetal death.
ISSN:1883-0498