Document Detail

Clinical difficulties and forensic diagnosis: histopathological pitfalls of villus mesenchymal dysplasia in the third trimester causing foetal death.
MedLine Citation:
PMID:  23821790     Owner:  NLM     Status:  In-Process    
In this article, the authors present a case of intrauterine foetal death (IUFD). The post-mortem histologic examination revealed placental mesenchymal dysplasia (PMD), a rare human placental disorder. Moreover, cases of PMD are often misdiagnosed as partial mole. The mother was a 26-year-old Italian, whose pregnancy, her first, had been uneventful until week 34⁺⁴ of gestation when IUFD suddenly occurred. The 2350 g male foetus showed no external abnormalities and the karyotype was 46, XY. The placenta weighed 450 g, the chorionic disk was round shaped, measuring 19.5-20.5 cm in diameter and had many enlarged villous structures. Histologically, the parenchyma showed abnormally enlarged and focally hydropic stem villi. Many of them were also surrounded by a fibrinoid material. Neither abnormal trophoblastic proliferation nor inclusion was observed in the examined sections. Causes and pathogenesis of PMD are still unclear and it is difficult to make a diagnosis solely on prenatal ultrasound during pregnancy. Generally, the correct diagnosis is reached only after the histological analysis of the placenta. However, obstetricians and gynaecologists should consider PMD also when a normal looking foetus is accompanied by a molar placenta (index factor for placentomegaly). The authors stress the importance of cooperation and information exchange among clinical and forensic pathologists, neonatologists, obstetricians and gynaecologists to avoid medical malpractice court proceedings in cases of IUFD.
Francesco Ventura; Mariangela Rutigliani; Carlo Bellini; Alessandro Bonsignore; Ezio Fulcheri
Publication Detail:
Type:  Journal Article     Date:  2013-05-01
Journal Detail:
Title:  Forensic science international     Volume:  229     ISSN:  1872-6283     ISO Abbreviation:  Forensic Sci. Int.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-07-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902034     Medline TA:  Forensic Sci Int     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  e35-41     Citation Subset:  IM    
Department of Legal and Forensic Medicine, University of Genoa, S. Martino Hospital, via de Toni 12, 16132 Genova, Italy.
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