Case Of Placental Mesenchymal Dysplasia Research Articles

EP15.29: Case of placental mesenchymal dysplasia with fetal growth restriction, postnatal follow‐up and histopathological correlation

EP15.29: Case of placental mesenchymal dysplasia with fetal growth restriction, postnatal follow‐up and histopathological correlation

A Rare Case of Biparental Placental Mesenchymal Dysplasia: A Case Report and Literature Review [ID: 1336615

INTRODUCTION: Placental mesenchymal dysplasia (PMD) is a rare placental anomaly associated with high perinatal mortality; it is predominantly seen in female fetuses and very few cases have been reported. The evaluation of first- and second-trimester products of conception is of the utmost importance when assessing molar pathologies such as complete hydatidiform moles, partial hydatidiform moles, and nonmolar samples. METHODS: We report a monochorionic 46XX,69XXY pregnancy with placental mesenchymal dysplasia (PMD) with possible androgenetic biparental mosaicism etiology (Instituto Nacional de Perinatología Isidro Espinosa de los Reyes approval number P-270-18). RESULTS: The patient is a 28-year-old gravida 2, para 1, female with no notable past medical history. She had a previous pregnancy resulting in an uncomplicated abdominal delivery at 39 weeks of gestation 5 years prior. The patient was transferred to our health center at 24.2 weeks of gestation with a molar component because of USG data consistent with a probable hepatic tumor, perimembranous ventricular septal defect, and probable PMD. Ultrasound at 24.3 weeks of gestation demonstrated a single intrauterine pregnancy with one-third of the placenta appearing normal, the second third showing irregular cystic masses, and the remaining third with larger cysts. Placental mesenchymal dysplasia was diagnosed retrospectively based on data from the gross, histologic, and genetic components. CONCLUSION: To our knowledge, this is the first reported case of PMD with a 46XX,69XXY karyotype. A radical and cautious approach to PMD cases is needed because of the lack of sufficient data and reports.

Placental mesenchymal dysplasia- A case report

Placental mesenchymal dysplasia is an underdiagnosed and a rare vascular anomaly of the placenta. It is characterized by the presence of grape-like vesicles, which, on ultrasonography gives the appearance of a partial mole. Histologically it can be differentiated by partial mole by the absence of trophoblastic proliferation. It is essential to make a correct diagnosis as the management and outcome of both these entities are vastly different. We present this case of placental mesenchymal dysplasia, not just because of its rarity but to highlight its radiological, gross and histopathological features to keep it in mind as a differential diagnosis and in making the correct diagnosis.

209 When placenta is the key… Placental mesenchymal dysplasia: A case report with bad outcome

Introduction and aims: Placental mesenchymal dysplasia (PMD) is a rare vascular and connective placental anomaly characterized by an enlarged and thickened placenta with multiple hypoechoic cystic spaces, which is often associated with severe fetal and/or maternal complications. We intend to discuss some severe complications of PMD to alert health professionals to the importance of this rare disease. Methods: We describe a case of undiagnosed PMD with several maternal and fetal complications. Results: A 23-years-old healthy primipara, had a complicated pregnancy with gestational diabetes and no apparent fetal malformations.

Placental mesenchymal dysplasia: a case report and literature review

Objective To summarize the clinical, sonographic and pathological characteristics, and the perinatal outcomes of pregnancies complicated by placental mesenchymal dysplasia (PMD). Methods We reported the diagnosis and treatment of a case of PMD in Tianjin Union Medical Center. Pertinent Chinese literatures on PMD were reviewed to analyze the clinical features and the outcomes for mothers and infants. Results (1) Case report: The patient was admitted to our hospital with elevated blood pressure in July 2011 and underwent caesarean section at 30+1 gestational weeks indicated by severe preeclampsia and fetal distress. PMD was diagnosed by placental pathological examination. The patient was discharged from the hospital after oral antihypertensives treatment with stabilized blood pressure. Both the mother and the child were healthy during follow-ups until August 2018. (2) Literature review: A total of 14 cases of PMD were reported domestically including the index case. The average maternal age was 27.9(23-42). Of all the 14 fetuses, half were born alive and half were died in the uterus; two were male, 10 were female and two of unknown sex. Sonographic findings of 10 cases showed thickened placenta with hypoechoic areas. Human chorionic gonadotropin (hCG) was tested in five cases, and the results were all normal. One case was tested for maternal serum alpha fetoprotein (AFP), which was increased. Among the 14 cases, there were two of preeclampsia, six of intrauterine death, three of fetal distress and one of the premature rupture of fetal membranes. Four out of the seven live births were born prematurely. According to the medical record, the average weight of placentas of seven gravidas was 665 g, and eight placentas were larger than the gestational age in size. Pathological examinations showed 11 placentas were covered with grape-like cystic vesicles. No trophoblastic proliferation or stromal trophoblastic inclusion was observed in 12 cases under the microscope. Conclusions PMD is mainly characterized by enlarged and cystic placenta with hypoechoic areas in sonographic findings as well as elevated AFP and normal hCG concentrations in serum. It is more likely to occur in female fetuses with normal karyotype. Placentas with significantly increased size and weight and grape-like cystic vesicles are typical features of PMD that can be detected by pathological examinations. Some gravidas may develop hypertensive disorders of pregnancy and deliver prematurely due to fetal distress, but the maternal and neonatal outcomes are usually good. Close monitoring of the gravidas and fetuses with PMD may help to improve pregnancy outcomes. Key words: Mesoderm; Placenta diseases; Diagnosis, differential; Pregnancy outcome

Placental Mesenchymal Dysplasia With Normal Fetus: A Rare Case Report

Placental mesenchymal dysplasia (PMD) is a rare benign placental abnormality. It is characterized by hydropic degeneration of stem villi, placentomegaly, and increased maternal serum alpha-fetoprotein (AFP). It can be associated with different congenital abnormalities, karyotype abnormalities, and feto-maternal morbidities. It is difficult to differentiate PMDfrom partial mole, complete mole with twin pregnancy in ultrasound, and in macroscopic examination. The current paper presentsa rare case of placental mesenchymal dysplasia in a young primigravida mother who delivered a normal fetus withnormal karyotype.

A case of placental mesenchymal dysplasia with one year follow-up

Placental mesenchymal dysplasia (PMD) is a rare placental disease with unknown etiology. Because of the malformation of the placenta, the incidence of the obstetric complications and the poor perinatal outcomes are higher than usual. PMD usually accompanies with Beckwith-Wiedemann syndrome. In this article, the authors report a case of PMD with a live delivery in 35+5 gestational weeks. The phenotype of the neonate was normal. During the one-year follow-up, the development of the child was normal.

Intrauterine Growth Restriction Associated with Hematologic Abnormalities: Probable Manifestations of Placental Mesenchymal Dysplasia

Introduction Placental mesenchymal dysplasia is a rare vascular disease associated with intrauterine growth restriction, fetal demise as well as Beckwith–Wiedemann syndrome. Some neonates present hematologic abnormalities possibly related to consumptive coagulopathy and hemolytic anemia in the placental circulation. Case report We present a case of placental mesenchymal dysplasia in a fetus with intrauterine growth restriction and cerebellar hemorrhagic injury diagnosed in the 20th week of pregnancy. During 26th week, our patient had an intrauterine fetal demise in the context of gestational hypertension. We have detailed the ultrasound findings that made us suspect the presence of hematologic disorders during 20th week. Discussion We believe that the cerebellar hematoma could be the consequence of thrombocytopenia accompanied by anemia. If hemorrhagic damage during fetal life is found, above all associates with an anomalous placental appearance and with intrauterine growth restriction, PMD should be suspected along other etiologies.

Placental Mesenchymal Dysplasia (PMD) in Association With Beckwith-Wiedemann Syndrome Identified by First Trimester Sonography

Placental mesenchymal dysplasia (PMD) has commonly been identified on second trimester ultrasound in association with Beckwith-Wiedemann syndrome (BWS). In this report, a case of PMD later confirmed as Beckwith-Wiedemann is presented, which was identified by sonography in the first trimester. When faced with a first trimester finding of an enlarged cystic placenta, it is suggested that BWS be considered as a possible diagnosis and accordingly, genetic testing with methylation studies offered to the parents.

Placental mesenchymal dysplasia with fetal gastroschisis.

Placental mesenchymal dysplasia (PMD) is a rare, benign condition characterized by placentomegaly and abnormal chorionic villi with vesicle formation, fibroblastic hyperplasia, and vascular abnormalities. This condition can be misdiagnosed as molar pregnancy due to similar ultrasonographic findings [1]; however, unlike molar pregnancy, a fetus is usually present and there is no risk of trophoblastic proliferative disease in PMD. The authors report a case of placental mesenchymal dysplasia at 15 weeks of gestation associated with fetal gastroschisis and high serum beta human chorionic gonadotropin (β-hCG) that mimicked molar pregnancy.

English

Placental mesenchymal dysplasia (PMD) is a rare, incompletely understood placental vascular lesion. Ultrasound and gross placental examination reveal placentomegaly and grape like vesicles that mimic molar pregnancy. PMD is often associated with normal foetus, diploid karyotyping and needs to be differentiated from its mimickers as the prognosis and management varies. Here in, we describe a case of PMD with ultrasound and histopathological correlation.

Placental Mesenchymal Dysplasia with Hepatic Mesenchymal Hamartoma: A Case Report and Literature Review

Placental mesenchymal dysplasia (PMD) is characterized by placentomegaly and grapelike vesicles resembling a partial molar pregnancy and in most cases, a phenotypically normal fetus. Hepatic mesenchymal hamartoma (HMH) is a benign hamartomatous proliferation of mesenchymal liver tissue. PMD has been associated with HMH. Although rare, in combination, it is known to carry a poorer prognosis than in fetuses without structural abnormalities. There are only a few reported cases of PMD and associated HMH with varying management strategies and outcomes, precluding ascertainment of the most appropriate treatment plan. We present a case of PMD with associated cystic HMH resulting in fetal death. We also reviewed the published literature on this issue and explored possible management strategies to prevent adverse fetal and neonatal outcomes.

PMD Initially Diagnosed as Partial Mole.

Placental mesenchymal dysplasia (PMD) is a rare condition of placentomegaly and abnormal chorionic villi often clinically mistaken as partial hydatidiform mole. However, it is clinico-pathologically distinct with high incidence of IUGR and fetal death [1]. We present a case of PMD which was initially suspected as a partial mole.

A case report of placental mesenchymal dysplasia with an increased VEGF-D expression

The pathogenesis of placental mesenchymal dysplasia (PMD) remains unclear. This report presents a case of PMD with a female fetus complicated with intrauterine growth restriction (IUGR). The ultrasound findings were similar to molar pregnancies, but PMD was suspected based on the presence of low β-hCG levels and a normal karyotype. After delivery, pathological examination of the placenta showed dilated villi and thick-walled vessels lacking trophoblast proliferation, which thus led to a diagnosis of PMD. The VEGF-D (Xp22.31) mRNA expression was found to have increased in the abnormal villi. Whether this is an incidental or X-linked gene specific event in, IUGR complicated, PMD pathogenesis warrants further investigation of VEGF-D expression in PMD.

Placental mesenchymal dysplasia

Placental mesenchymal dysplasia is a benign condition that can be confused with a molar pregnancy by ultrasound scanning and gross examination. Conservative management should be considered with a normal-appearing singleton fetus and a cystic-appearing placenta. We present a case of placental mesenchymal dysplasia with a favorable outcome.

Placental mesenchymal dysplasia: a potential misdiagnosed entity

Placental mesenchymal dysplasia is a rare condition characterized by enlarged multicystic placenta with anechoic regions on ultrasound. Gross examination shows grapelike vesicles which mimics molar pregnancy. Microscopic findings shows large edematous villi with cistern formation interspersed with normal villi. The absence of trophoblastic proliferation and trophobastic inclusions differentiates it from molar pregnancy. We report a new case of placental mesenchymal dysplasia. A 31-year-old G2P1 presented with preterm vaginal bleeding at 24 5/7 weeks of gestation. Ultrasound findings show cystic placenta and placenta previa. She went into preterm labor and delivered a female baby with no dysmorphic features but later suffered from complications of prematurity. Pathologically, the placenta showed multiple grapelike cystic vesicles with unremarkable chorionic vessels. Microscopically, enlarged edematous villi with cistern formation were noted. Trophoblastic proliferation or inclusions were not seen.

Displasia mesenquimatosa de placenta

We present a case of placental mesenchymal dysplasia associated with fetal serous cystoadenoma of the pancreas.