Placenta membranacea

Abstract

Placenta membranacea is a rare placental disorder characterized by the presence of fetal membranes (complete or partially) covered by chorionic villi. A 35-year-old woman, gravida 1, was admitted for preterm labor at 24 weeks and 5 days. She subsequently developed heavy vaginal bleeding and underwent a classical cesarean delivery for suspected abruption. Postpartum inspection of the placenta demonstrated a small placenta with tan colored membranes, and diffusely scattered placental cotyledons. Histologic examination revealed chorionic villi directly attached to the fetal membranes on the periphery,consistent with the diagnosis of a partial placenta membranacea. Placenta membranacea should be considered in the etiology of painless vaginal bleeding in the second and third trimester. This condition can be associated with other placental abnormalities, such as placenta previa or accreta. Perinatal outcome may include stillbirth, preterm delivery, or neonatal death.

Placenta membranacea with placenta accreta: radiologic diagnosis and clinical implications

“…We searched MEDLINE using PubMed for all English‐language articles published until 2013 with search terms ‘placenta membranacea’, ‘placenta diffusa’, ‘placenta accreta’, ‘hemorrhage’, and ‘cesarean hysterectomy.’ Our search returned 18 publications pertaining to this subject. In all publications, the diagnosis of placenta membrancea was achieved by post‐delivery pathologic examination of the placenta . On the basis of this search, our report represents the first case of the antenatal diagnosis of placenta membranacea using magnetic resonance imaging (MRI).…”

“…In all publications, the diagnosis of placenta membrancea was achieved by post-delivery pathologic examination of the placenta. 3 On the basis of this search, our report represents the first case of the antenatal diagnosis of placenta membranacea using magnetic resonance imaging (MRI).…”

“…2,7 Repeated endometritis, mechanical injury to the endometrium, and endometrial hyperplasia may also contribute to the pathogenesis of placenta membranacea. [1][2][3][4][5][6] Placenta membranacea has also been associated with abnormal placental adherence in up to one third of the cases reported in the medical literature. [3][4][5][6] Clinical symptoms associated with this placental abnormality range from antenatal bleeding to preterm birth and fetal loss.…”

“…[1][2][3][4][5][6] Placenta membranacea has also been associated with abnormal placental adherence in up to one third of the cases reported in the medical literature. [3][4][5][6] Clinical symptoms associated with this placental abnormality range from antenatal bleeding to preterm birth and fetal loss. [1][2][3][4][5][6] In a recent literature review of 41 pregnancies complicated by placenta membranacea, Ravangard et al 3 estimate 31 out of 41 cases (75.6%) to be associated with preterm birth, of which 6 cases (14%) occurred at a gestational age of less than 23 weeks.…”

“…[3][4][5][6] Clinical symptoms associated with this placental abnormality range from antenatal bleeding to preterm birth and fetal loss. [1][2][3][4][5][6] In a recent literature review of 41 pregnancies complicated by placenta membranacea, Ravangard et al 3 estimate 31 out of 41 cases (75.6%) to be associated with preterm birth, of which 6 cases (14%) occurred at a gestational age of less than 23 weeks. They also highlight that 33 out of 40 cases (82.5%) were associated with antenatal bleeding and that the overall live birth rate associated with placenta membranacea is 57.9%.…”