A Case of Placental Mesenchymal Dysplasia

Abstract

Placental mesenchymal dysplasia (PMD) rarely complicates with pregnancy. A 30-year-old woman, gravida 3, para 3, presenting with placentomegaly, was referred to our department at 18 weeks of gestation. An ultrasonography revealed a normal fetus with a large multicystic placenta, measuring 125 × 42 × 80 mm. The border between the lesion and normal region was not clear. Color doppler revealed little blood flow in the lesion. Magnetic resonance imaging revealed normal fetus and a large multicystic placenta. Serum human chorionic gonadotropin level was 20124.97 U/L, which was normal at 20 weeks of gestation. Thus, placental mesenchymal dysplasia rather than hydatidiform mole with coexistent fetus was suspected. Then, routine checkup was continued. Because she had the history of Cesarean section, an elective Cesarean section was performed at 37 weeks of gestation, and 2520 g female infant with apgar score 8/9 was delivered. The baby was normal with no evidence of Beckwith-Wiedemann syndrome. Placenta of 20 × 16 × 2 cm, weighing 720 g, was bulky with grape like vesicles involving whole placenta. Microscopic examination revealed dilated villi and vessels with thick wall which was lacking trophoblast proliferation. Large hydropic stem villi with myxomatous struma and cistern formation were seen. PMD was histopathologically confirmed.

Prospective risk of stillbirth in women with placental mesenchymal dysplasia

“…Only 25 (22.9%) women had full‐term (GW ≥ 37) live‐born infants (Fig. ) . Of the 25 infants born to these women, including one with an unspecified birthweight, 15 (60%) were documented to be born with a low birthweight < 2500 g (six were < 2000 g) …”

“…The search term ‘placental mesenchymal dysplasia’ yielded a list of 88 published reports. Of these, 50 were included in the present analysis because information was available regarding individual data on PMD pregnancies with GW ≥ 24 in the English language . In addition, a further 13 reports that appeared in the reference lists of pertinent reports were also included in our analysis.…”

“…We identified a total of 63 reports describing a total of 107 PMD pregnancies with GW ≥ 24. These included 50 dealing with single cases, eight with two cases, one with four cases, one with five cases, two with nine cases, and one with 14 cases …”

Displasia mesenquimal placentaria: caso clínico

“…La placenta se describe como quística con imágenes hipoecogénicas (80%), engrosamiento y/o placentomegalia (50%) y dilatación de vasos de la placa coriónica (16%) (3)(4)(5)(6)8). Los niveles séricos de gonadotrofina coriónica humana pueden ser normales o estar levemente aumentados, la alfa fetoproteína generalmente está elevada y en ambos casos los valores se normalizan posparto (9).…”

Unusual markedly-dilated chorionic vessels with placentomegaly

“…There have been limited papers that reported on anomalies of the chorionic vessels, although venous anomaly of those is clinically important because it may threaten the life of the fetus. Recently, placental mesenchymal dysplasia (PMD) has been reported as a benign entity of the placenta (Taga et al 2013 ). PMD was described for the first time by Moscoso et al in 1991 (Moscoso et al 1991 ).…”