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Open Access Highly Accessed Case Report

Placental mesenchymal dysplasia, a case of intrauterine sudden death of fetus with rupture of cirsoid periumbilical chorionic vessels

Takeshi Umazume1, Soromon Kataoka1*, Kyouko Kamamuta1, Fumie Tanuma1, Akihiko Sumie1, Toru Shirogane1, Takayuki Kudou1 and Hitoshi Ikeda2

Author Affiliations

1 Department of Obstetrics and Gynecology, Hakodate Central General Hospital, Honchou 33-2, Hakodate, 040-8585, Japan

2 Department of Pathology, Hakodate Central General Hospital, Honchou 33-2, Hakodate, 040-8585, Japan

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Diagnostic Pathology 2011, 6:38  doi:10.1186/1746-1596-6-38

Published: 24 April 2011

Abstract

We report a 32-year-old woman (1-gravid, 1-para) with a vesicular lesion in her uterus that was pointed out on ultrasound at 8 weeks' gestation. Amniocentesis at 15 weeks' gestation showed a normal female karyotype, 46XX. As the pregnancy advanced, the mole-like lesion became relatively reduced. Throughout gestation, the maternal human chorionic gonadotropin level was normal, but the serum alpha fetoprotein level rose as her pregnancy progressed. Her fetus did not exhibit any remarkable anomalies. The patient visited our hospital complaining of a diminished feeling of fetal movements at 36 weeks 5 days' gestation, and intrauterine fetal death (IUFD) was confirmed. She delivered a 2336-g female without any definite anomalies. A pathological examination led to a diagnosis of placental mesenchymal dysplasia, and androgenetic/biparental mosaicism in the placenta was identified using p57kip2 immunohistochemical staining. And it also revealed that the rupture of the cirsoid chorionic vessels had led to IUFD.

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