Mesenchymal dysplasia of the placenta

Abstract

A severe case of placental mesenchymal dysplasia occurred in association with intrauterine fetal death (IUFD). The gravida‐1, para‐1 mother was a 26‐year‐old Japanese. The first pregnancy was unremarkable and a healthy female infant was delivered. The present pregnancy had been uneventful until 34 weeks of gestation when IUFD was detected. The 1516‐g (mean ± SD, 2050 ± 387 g) stillborn infant had no external abnormalities and the karyotype was 46,XX. The placenta was markedly enlarged (1050 g; mean ± SD, 452 ± 202 g), and approximately 80% was occupied by extraordinary enlarged villous structures with a myxoid appearance. Histologically, the dysplastic villi had myxoid stroma and a decreased number of, occasionally obliterated, fetal vessels. There was no abnormal trophoblastic proliferation. Large‐sized fetal vessels in the chorionic plate frequently contained organized thrombi. This is the first case of placental mesenchymal dysplasia, which possibly lead to the IUFD.

Placental Mesenchymal Dysplasia: Chronological Observation of Placental Images during Gestation and Review of the Literature

“…Of the 110 cases reviewed, 16 (14.5%) were associated with BWS [2,3,4,5,6,7,8,9,10], 33 (30.0%) had evidence of fetal growth restriction [4,11,12,13,14,15,16,17,18,19,20,21,22,23,24,41,46,48] as in the current case, and 28 (25.5%) ended in intrauterine fetal death [4,6,7,8,12,13,15,16,17,18,25,26,45,47]. There is a female preponderance in cases of PMD; of the infant data reviewed, there were 78 females and 19 males.…”

“…Another characteristic feature of PMD is aneurismal and varicose dilation of fetal chorionic vessels. Of the 110 cases reviewed, 48 cases of PMD presented data of dilation of fetal chorionic vessels [2,3,9,11,12,13,14,15,17,18,20,21,22,23,24,26,34,35,36,40,41,44,45,46,47,48]. Figure 6 represents the gestational age when aneurismal and varicose dilation of chorionic vessels were identified in the 48 cases and the current case.…”

“…All articles without an abstract or with unavailable full text were excluded. We identified 49 articles including 110 cases of PMD [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49]. …”

Placental mesenchymal dysplasia associated with trisomy 13: Sonographic findings

“…[1][2][3] Prenatal sonography often reveals multiple cystic areas within the placenta, suggesting a partial hydatidiform mole (PHM). Although PMD is generally accepted as a rare entity, there has been an increasing number of case series [1][2][3][4] and case reports 5,6 in recent literature regarding this condition. Approximately one quarter of the reported cases of PMD are associated with fetal Beckwith-Wiedemann syndrome (BWS).…”

Displasia mesenquimal placentaria

“…Esta anomalía es una malformación limitada al mesénquima extraembrionario que envuelve al mesodermo y los vasos de la vellosidad troncal de varios cotiledones (2) . Se le ha encontrado asociada al síndrome de Beckwith-Wiedemann (3) , hamartoma mesenquimal hepático fetal (4) , restricción del crecimiento intrauterino (RCIU) (5) , muerte fetal intrauterina (6) , placenta previa (7) , feto anatómicamente normal asociado con cariotipo 46XX (8) , hiperplasia adrenal congénita fetal (9) y malformación de la pared abdominal anterior fetal (10) . Una de las principales características de esta anomalía es la presencia de vasos vellosos troncales aneurismales, los cuales, en cortes histológicos de 4-5 µm, pueden ser confundidos con otras alteraciones vasculares, como corioangioma, corioangiosis o corioangiomatosis, originadas en la misma región de la placa coriónica.…”