Placental Mesenchymal Dysplasia Presenting as a Twin Gestation With Complete Molar Pregnancy

Abstract

Although placental mesenchymal dysplasia is often confused with molar pregnancy, it is important to consider both in a differential to avoid inappropriate treatments.

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.…”

“…Of the 110 cases reviewed, 44 cases of PMD showed multicystic placenta in antenatal ultrasound scan [1,2,3,5,7,9,10,11,12,13,16,18,19,20,22,23,26,27,28,29,30,31,32,33,34,41,42,43,44,45,46,47,48]. Figure 5 represents the gestational age at which the multicystic pattern was identified in the 44 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

“…In addition, subchorionic hemorrhage may mimic PMD, owing to the cystic spaces seen on ultrasonography. [10][11][12][13][14][15] In conclusion, PMD is a relatively rare entity that needs to be distinguished from molar pregnancy to clinically prevent unnecessary termination of the pregnancy. 9 If PMD is suspected after antenatal ultrasonography and genetic testing, it is imperative that affected patients be followed up as patients with high-risk pregnancies owing to the association with growth restriction, stillbirth, and other chromosomal abnormalities.…”

Placental Mesenchymal Dysplasia

“…Therefore, not all PMD cases will have the same proportion of abnormal villi showing ABM and/or the same degree of fetal development or pathology. The reported cases of PMD range from *30 % to 100 % involvement of the placenta [41][42][43]. It is possible that in some placentas with even smaller percentages of involvement, the cystic changes may be overlooked while those with 100 % involvement may not develop a fetus [41].…”