Next skip An Fac med. Una Abstract Placental mesenchymal dysplasia is a rare condition of placentomegaly and abnormal chorionic villous, often clinically confused as partial hydatidiform mole. However, it is different clinically and pathologically, with high incidence of intrauterine growth restriction and stillbirth. We present the clinical course of a pregnant woman carrying placental mesenchymal dysplasia, the first case diagnosed at the Maternal Perinatal National Institute, how to suspect diagnosis and gestational care. There was need for caesarean section at 27 weeks gestation, obtaining a 1 g newborn girl, with Apgar 8 at the first minute and 9 at the fifth minute, bloody amniotic fluid in regular quantity and placentomegaly.
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Case we report the case of year-old woman 1-gravid who visited our clinic at 11 weeks of gestation due to a suspected molar pregnancy. Ultrasound examination showed an enlarged placenta with multiple vesicular lesions. Maternal human chorionic gonadotropin level was normal and chorionic villus sampling showed a normal male karyotype 46 XY. The fetus exhibited no specific anomalies and fetal growth was normal during pregnancy with no signs of fetal suffering.
At 31 weeks, the pregnancy ended owing to intrauterine fetal death IUFD. The patient delivered a normal-sized male fetus g with no definite anomalies. A pathological examination led to a diagnosis of placental mesenchymal dysplasia. Conclusion in the presence of placental ultrasound anomalies with no other sign of fetal suffering, the pregnancy should be considered at risk and, therefore, should be monitored carefully including the option of hospitalization.
Keywords: placental dysplasia, intrauterine death, molar pregnancy Introduction Placental mesenchymal dysplasia PMD is a rare placental anomaly characterized by placentomegaly and grape like vesicles which resemble molar pregnancy. The incidence of PMD is reported to be 0. Distinguishing PMD from its mimics, especially molar pregnancy, is important in order to prevent the unnecessary termination of pregnancy. Unlike molar pregnancies, PMD usually involves a normal fetus.
However, PMD has a high incidence of fetal growth restriction FGR and intrauterine fetal death IUFD , and it has been associated with Beckwith-Wiedemann syndrome macrosomia, visceromegaly, macroglossia, and omphalocele 2. Pathologically, in PMD, placentas are usually large in size and show edema of stem villi with intact terminal villi and many kinds of vascular anomalies, such as cirsoid chorionic vessels, thrombosis, thickening of vessel wall, vascular stenosis, villous chorangiosis, chorioangioma and fetal thrombotic vasculopathy.
There have also been reports of umbilical cords, including tortuous, marked twisted cords, and excessively long cords 3 , 4. Absence of trophoblastic proliferation in PMD placentas is the main histological difference from partial moles. We report a case of PMD with intrauterine sudden death of a normal-sized fetus. Case presentation A year old woman with a completely negative anamnesis at her first pregnancy was referred to our centre at 11 weeks of gestation on account of a suspected molar pregnancy.
Our scan showed a normal size fetus crown-rump length 45 mm with no detectable anomalies at that gestation time and an enlarged placenta with multiple vesicular lesions Figs. The Doppler study excluded abnormal trophoblastic vascularization.
Displasia Mesenquimal Placentaria. Panorama en México
Myxoid chondrosarcoma is a rare histologic variant of chondrosarcoma, and is characterized by abundant chondroid matrix and malignant chondroblastic cells arranged in cords resembling chordoma. Pathology Outlines — Mesenchymal dysplasia Prenatal differential diagnosis of complete hydatidiform mole with a twin live fetus and placental mesenchymal dysplasia by magnetic resonance imaging. CT is the first modality of choice in the diagnosis of chondrosarcoma in sinonasal and orbital region. Organizing hematomas of the paranasal sinuses are diagnostic dilemmas clinically and radiographically, mimicking benign or malignant neoplastic processes and causing patients and clinicians undue worry regarding these diagnoses. In the case of frontal sinusitis, an endoscopic transaxillary approach was utilized to avoid injury to decompressed orbital contents. One LENT grade 1 vascular retinopathy dispkasia 1 optic neuropathy were also observed. Sinonasal quality of life outcomes following laser treatment of epistaxis related to hereditary hemorrhagic telangiectasia.
DISPLASIA MESENQUIMAL PLACENTARIA PDF
Dado que en la ecografia de las 34 semanas se objetivo un peso fetal estimado en el percentil 5, se decidio la finalizacion del embarazo mediante induction; el parto fue espontaneo y nacio una nina sana de 1. Figura 3. Cara materna de la placenta, cordon anomalo. Cara fetal de la placenta. La descripcion macroscopica informo de un cordon umbilical de insercion anomala en asta, con vasos prominentes y dilatados; la cara fetal placentaria no presentaba alteraciones, mientras que la cara materna era blanquecina, con cotiledones poco lobulados y que a la seccion presentaba quistes de contenido liquido transparente, con microgranulaciones y microvesiculas.
Placental mesenchymal dysplasia, a case of intrauterine sudden death in a normal-sized fetus
This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Correspondencia: Dra. Ribot Luna.