Abstract
Maternal floor infarction (MFI) and its related disorder massive perivillous fibrin deposit (MPFD) is an uncommon placental abnormality of unknown pathogenesis. The condition is associated with adverse perinatal outcome, including spontaneous abortion, preterm delivery, fetal growth restriction, stillbirth, and long term neurologic impairment as well as recurrent risk in subsequent pregnancies. By definition, the fibrinoid deposition is confined to basal villi along the decidual basalis in MFI, whereas the deposition is more widely distributed throughout placenta in MPFD and may even be transmural. Both conditions can overlap since the distribution of fibrinoid material is not always distinctively different in some cases, suggesting MFI and MPFD are different manifestations of the same condition. MFI has been linked to underlying maternal disorders, including gestational hypertension, autoimmune disease and thrombophilia. The author reports a focal involvement of MFI in a stillborn female fetus belonging to 9-year-old mother who has an underlying disease of systemic lupus erythematosus. To the best knowledge, this is the first case demonstrating the peculiar gross feature of MFI. The variation hemodynamic pattern in the different region in the placenta and immunologic reaction may play a role in such pathologic setting.
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