Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction
Abstract Background Placental mesenchymal dysplasia (PMD) is a rare, benign, placental disorder characterised macroscopically by an enlarged multi-cystic placenta. It is a condition associated with a range of reported clinical outcomes and can be misdiagnosed as a molar or partial molar pregnancy gi...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-11-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-024-06960-8 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850064567655202816 |
|---|---|
| author | Thomas Chadwick Jennifer Davis Wafa Bitar Susmita Pankaja |
| author_facet | Thomas Chadwick Jennifer Davis Wafa Bitar Susmita Pankaja |
| author_sort | Thomas Chadwick |
| collection | DOAJ |
| description | Abstract Background Placental mesenchymal dysplasia (PMD) is a rare, benign, placental disorder characterised macroscopically by an enlarged multi-cystic placenta. It is a condition associated with a range of reported clinical outcomes and can be misdiagnosed as a molar or partial molar pregnancy given the similarities in clinical presentation. We present an unusual case of PMD complicated by fetal growth restriction and oligohydramnios in the second trimester. Case presentation A 33 year old female was referred to our fetal medicine unit with a multi-cystic placenta at dating scan suspected initially to be a partial molar pregnancy. She opted for conservative management and declined invasive testing. At 16 weeks severe fetal growth restriction was present with an estimated fetal weight < 3rd centile and associated with oligohydramnios. Whilst live births in cases of PMD have been reported in the literature, to our knowledge there are no reported successful outcomes in cases of early onset growth restriction at this gestation. The patient opted to proceed with termination of pregnancy given the suspected poor prognosis. Post mortem results confirmed a diagnosis of PMD and fetal growth restriction with normal genetic testing. Conclusions Placental mesenchymal dysplasia can be a difficult condition to manage, particularly when counselling about prognosis and deciding whether to continue the pregnancy. More evidence is needed about prognostic factors in PMD associated with a successful outcome. Early onset fetal growth restriction and/or oligohydramnios prior to 20 weeks are likely poor prognostic factors which should be considered in the antenatal counselling. |
| format | Article |
| id | doaj-art-120d12d24342467baf7aa4c27ae7d414 |
| institution | DOAJ |
| issn | 1471-2393 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-120d12d24342467baf7aa4c27ae7d4142025-08-20T02:49:16ZengBMCBMC Pregnancy and Childbirth1471-23932024-11-012411510.1186/s12884-024-06960-8Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restrictionThomas Chadwick0Jennifer Davis1Wafa Bitar2Susmita Pankaja3Obstetrics & Gynecology department, Whiston HospitalObstetrics & Gynecology department, Whiston HospitalObstetrics & Gynecology department, Whiston HospitalObstetrics & Gynecology department, Whiston HospitalAbstract Background Placental mesenchymal dysplasia (PMD) is a rare, benign, placental disorder characterised macroscopically by an enlarged multi-cystic placenta. It is a condition associated with a range of reported clinical outcomes and can be misdiagnosed as a molar or partial molar pregnancy given the similarities in clinical presentation. We present an unusual case of PMD complicated by fetal growth restriction and oligohydramnios in the second trimester. Case presentation A 33 year old female was referred to our fetal medicine unit with a multi-cystic placenta at dating scan suspected initially to be a partial molar pregnancy. She opted for conservative management and declined invasive testing. At 16 weeks severe fetal growth restriction was present with an estimated fetal weight < 3rd centile and associated with oligohydramnios. Whilst live births in cases of PMD have been reported in the literature, to our knowledge there are no reported successful outcomes in cases of early onset growth restriction at this gestation. The patient opted to proceed with termination of pregnancy given the suspected poor prognosis. Post mortem results confirmed a diagnosis of PMD and fetal growth restriction with normal genetic testing. Conclusions Placental mesenchymal dysplasia can be a difficult condition to manage, particularly when counselling about prognosis and deciding whether to continue the pregnancy. More evidence is needed about prognostic factors in PMD associated with a successful outcome. Early onset fetal growth restriction and/or oligohydramnios prior to 20 weeks are likely poor prognostic factors which should be considered in the antenatal counselling.https://doi.org/10.1186/s12884-024-06960-8Placental mesenchymal dysplasiaFetal growth restrictionBeckwith-Weidemann syndromeMolar pregnancyPlacentalomegaly |
| spellingShingle | Thomas Chadwick Jennifer Davis Wafa Bitar Susmita Pankaja Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction BMC Pregnancy and Childbirth Placental mesenchymal dysplasia Fetal growth restriction Beckwith-Weidemann syndrome Molar pregnancy Placentalomegaly |
| title | Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction |
| title_full | Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction |
| title_fullStr | Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction |
| title_full_unstemmed | Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction |
| title_short | Placental mesenchymal dysplasia: a rare case associated with second trimester fetal growth restriction |
| title_sort | placental mesenchymal dysplasia a rare case associated with second trimester fetal growth restriction |
| topic | Placental mesenchymal dysplasia Fetal growth restriction Beckwith-Weidemann syndrome Molar pregnancy Placentalomegaly |
| url | https://doi.org/10.1186/s12884-024-06960-8 |
| work_keys_str_mv | AT thomaschadwick placentalmesenchymaldysplasiaararecaseassociatedwithsecondtrimesterfetalgrowthrestriction AT jenniferdavis placentalmesenchymaldysplasiaararecaseassociatedwithsecondtrimesterfetalgrowthrestriction AT wafabitar placentalmesenchymaldysplasiaararecaseassociatedwithsecondtrimesterfetalgrowthrestriction AT susmitapankaja placentalmesenchymaldysplasiaararecaseassociatedwithsecondtrimesterfetalgrowthrestriction |