Placental mesenchymal dysplasia: An underdiagnosed placental pathology with various clinical outcomes

Guenot, Cécile; Kingdom, John; Rham, Maud de; Osterheld, Maria‐Chiara; Keating, Sarah; Vial, Yvan; Mieghem, Tim Van; Jastrow, Nicole; Raio, Luigi; Spinelli, Marialuigia; Meglio, Letizia Di; Chalouhi, G. E.; Baud, David

doi:10.1016/j.ejogrb.2019.01.014

Cited by 27 publications

(26 citation statements)

References 31 publications

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“…Similarly, our study found that FD onset occurred during gestational weeks 20–36. The mortality rate decreased to 17.0%, similar to results from a recent European multicenter study (18.0%, four of 22 patients) 20 . Of 39 live births, 23 (59.0%) were associated with premature induction of labor or cesarean section after gestational week 24; these cases were strongly related to FGR.…”

Section: Discussionsupporting

confidence: 86%

Clinical manifestations of placental mesenchymal dysplasia in Japan: A multicenter case series

Kodera

Aoki

Ohba

et al. 2021

J of Obstet and Gynaecol

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Aim This study aimed to evaluate the clinical features and pregnancy outcomes of placental mesenchymal dysplasia (PMD) in Japan. Methods We requested detailed clinical information and placental tissue of PMD cases in 2000–2018 from Japanese facilities with departments of obstetrics and gynecology and analyzed the pregnancy course and neonatal outcomes. Results We collected 49 cases of PMD. Of 18 patients with measured maternal serum alpha‐fetoprotein (MSAFP) levels, 15 (83.3%) had elevated levels. Maternal serum human chorionic gonadotropin (MShCG) levels were transiently elevated in five (17.8%) of 28 patients. Forty‐seven patients continued their pregnancies. All pregnancies were singleton and 40 (85.1%) were associated with adverse events including fetal growth restriction (FGR), threatened premature delivery, fetal demise, and hypertensive disorder of pregnancy in 34 (72.3%), 14 (29.8%), eight (17.0%), and six (12.8%) patients, respectively. Of 47 infants, there were eight stillbirths. There were 40 (85.1%) female infants, and eight (17.0%) had Beckwith–Wiedemann syndrome. Of 39 live births, 23 (59.0%) were associated with premature induction of labor or cesarean section for obstetric indications related to FGR. Eighteen (46.2%) neonates had complications. PMD‐affected placentas were pathologically heterogeneous in both grossly PMD‐affected and non‐affected areas. Conclusions Our study included the largest number of PMD cases with detailed clinical information. PMD is a high‐risk condition for both the mother and the child. Elevated MSAFP levels with normal MShCG levels indicate PMD. Conventional perinatal management of FGR in Japan might be effective in reducing the fetal mortality rate.

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Section: Discussionsupporting

confidence: 86%

Clinical manifestations of placental mesenchymal dysplasia in Japan: A multicenter case series

Kodera

Aoki

Ohba

et al. 2021

J of Obstet and Gynaecol

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“…La característica distintiva es el hallazgo de concentraciones séricas crecientes de alfafetoproteína materna. El aumento del área de la superficie de transferencia, como consecuencia del aumento del volumen placentario, y los vasos anormales de paredes delgadas dentro de las vellosidades troncales son fundamentales para el paso anormalmente creciente de alfafetoproteína a la circulación materna (11) . Por otro lado, las concentraciones de gonadotropina coriónica humana pueden permanecer normales o aumentar ligeramente durante el embarazo y volver a la normalidad después del parto (5) .…”

Section: Discussionunclassified

Diagnóstico prenatal de displasia mesenquimal placentaria

Torres-Cepeda

Rondón-Tapía

2021

Rev peru ginecol obstet.

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La displasia mesenquimal placentaria es una anomalía placentaria benigna y rara. Está caracterizada por placentomegalia con múltiples lesiones quísticas de las vellosidades troncales y anomalías vasculares junto con el aumento de las concentraciones séricas maternas de alfafetoproteína. Es una entidad clínica desconocida y puede confundirse con enfermedad trofoblástica gestacional debido a los hallazgos ecográficos similares en ambas entidades; pero, el manejo y la resultante perinatal son diferentes. Debe incluirse en el diagnóstico diferencial de los hallazgos ecográficos que muestran feto de apariencia normal y placenta con lesiones quísticas. No obstante, la displasia mesenquimal placentaria está asociada a complicaciones como restricción del crecimiento intrauterino y muerte fetal intrauterina. Debido al alto número de complicaciones y patologías asociadas, es necesario aumentar las evaluaciones ecográficas para disminuir la morbimortalidad fetal. Se presenta un caso de diagnóstico prenatal de displasia mesenquimal placentaria con feto normal.

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“…The majority of studies reporting outcomes among cases with confirmed PMD report poor fetal outcome and multiple maternal complications. However, normal fetal outcomes have been reported mainly as random case reports [40]. In a recent study the maternal, fetal and newborns complications of 22 cases with confirmed PMD were reported [41].…”

Section: Pregnancy Complications and Outcomementioning

confidence: 99%

“…PMD can be associated with fetal Beckwith-Wiedemann syndrome (BWS), fetal tumors of various organs, fetal growth restriction as well as intrauterine and neonatal death. It is probably under-diagnosed and under-reported because many healthcare providers, including pathologists and sonologists, are unfamiliar with the clinical entity [4].…”

Section: Introductionmentioning

confidence: 99%

Placental Mesenchymal Dysplasia; Current Understanding of the Sonographic, Histologic, and Molecular Findings of a Rare and Challengin Disorder

Lazebnik

2020

JGWH

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Placental mesenchymal dysplasia: An underdiagnosed placental pathology with various clinical outcomes

Cited by 27 publications

References 31 publications

Clinical manifestations of placental mesenchymal dysplasia in Japan: A multicenter case series

Clinical manifestations of placental mesenchymal dysplasia in Japan: A multicenter case series

Diagnóstico prenatal de displasia mesenquimal placentaria

Placental Mesenchymal Dysplasia; Current Understanding of the Sonographic, Histologic, and Molecular Findings of a Rare and Challengin Disorder

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