Prenatal sonographic findings and management of placental mesenchymal dysplasia

Abstract

Prenatal sonographic findings and management of placental mesenchymal dysplasia Suchaya Luewan1 , Pakorn Chaksuwat1 , Tip Pongsuvareeyakul2 , Theera Tongsong1, * 1Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University, 50200 Chiang Mai, Thailand 2Department of Pathology, Faculty of Medicine Chiang Mai University, 50200 Chiang Mai, Thailand *Correspondence: theera.t@cmu.ac.th (Theera Tongsong) DOI:10.31083/j.ceog.2021.02.2194 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 20 June 2020 Revised: 22 August 2020 Accepted: 31 August 2020 Published: 15 April 2021 Placental mesenchymal dysplasia (PMD) is a rare disorder of the placenta characterized by placentomegaly with diȞfuse hydropic stem villous, aneurysmally dilated vessels, and lack of trophoblastic proliferation. Case: The prenatal ultrasound of a 34-year-old woman (G1P0) at 33 weeks of gestation showed an enlarged placenta with multiple cystic lesions, heterogeneous echoes with no active blood Ƞlow, and fetal growth restriction (FGR). The diȞferential diagnosis involved partial mole, placental hemorrhage, and PMD. She developed preeclampsia at 38 weeks of gestation and gave birth to a normally formed, growth-restricted baby. The placenta, weighing 785 g, showed scattered cystic vesicles in the parenchyma. The histology shows enlarged edematous stem villi with occasional cistern formation and no area of chorioangioma or features of molar pregnancy. PMD associated fetal growth restriction was diagnosed. Conclusion: PMD has prenatal ultrasound result resembling those of partial mole, placental hemorrhage and chorioangioma, but the fetus is phenotypically normal. Nevertheless, fetal surveillance is essential. Keywords Placental mesenchymal dysplasia; Prenatal diagnosis; Ultrasound