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

Détails

ID Serval
serval:BIB_1202DA1F607C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Placental mesenchymal dysplasia: An underdiagnosed placental pathology with various clinical outcomes.
Périodique
European journal of obstetrics, gynecology, and reproductive biology
Auteur(s)
Guenot C., Kingdom J., De Rham M., Osterheld M., Keating S., Vial Y., Van Mieghem T., Jastrow N., Raio L., Spinelli M., Di Meglio L., Chalouhi G., Baud D.
ISSN
1872-7654 (Electronic)
ISSN-L
0301-2115
Statut éditorial
Publié
Date de publication
03/2019
Peer-reviewed
Oui
Volume
234
Pages
155-164
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Placental mesenchymal dysplasia (PMD) is a rare vascular and connective placental anomaly, which is often associated with severe fetal and/or maternal complications. The diversity of presentation of PMD challenges diagnosis and effective pregnancy management.
We aimed to review cases presenting at 7 tertiary centers worldwide over the last decade and to study the occurrence of obstetric and neonatal complications.
Pathology databases from 7 tertiary hospitals were screened for cases of PMD (between 2007-2017). Pregnancy history, outcomes and ultrasound images were then reviewed for each case.
Twenty-two cases of PMD were identified. Mean gestational age at diagnosis was 23 weeks (16-39 weeks). Prenatal biochemical screening was abnormal in 8 cases (36%). Of the 12 cases that underwent invasive genetic testing, 4 were abnormal. Six patients (27%) developed maternal complications (preeclampsia/gestational hypertension). Fetal growth restriction was identified in 11 cases (50%) and fetal death in 4 (18%). Four (18%) pregnancies were terminated, 9/14 (64%) delivered preterm and only three (14%) progressed normally. Fourteen babies were born alive; 5 (35%) died in the first sixty-one days after birth, 5 (35%) had transient thrombopenia and 1 (7%) had developmental delay at last follow-up. Our series identified four potential new associations with PMD: placental triploidy mosaicism, CHARGE syndrome, fetal pleuropulmonary blastoma and fetal skeletal dysplasia.
PMD was substantially under-diagnosed before delivery in this cohort. Sonographers, fetal medicine specialists, obstetricians and pathologists should all suspect PMD in cases of an enlarged placenta and should look for fetal abnormalities. Diagnostic genetic testing should be discussed to exclude partial molar pregnancy. Close pregnancy follow-up is indicated due to the high risk of associated fetal or maternal adverse outcomes.
Mots-clé
Adult, Female, Gestational Age, Humans, Placenta/pathology, Placenta Diseases/diagnostic imaging, Placenta Diseases/pathology, Pregnancy, Pregnancy Complications/etiology, Pregnancy Complications/pathology, Ultrasonography, Prenatal, Mesenchymal dysplasia, Molar pregnancy, Placenta, Placentomegaly
Pubmed
Web of science
Création de la notice
25/03/2019 8:42
Dernière modification de la notice
20/08/2019 12:39
Données d'usage