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Systematic review of sonographic findings of placental mesenchymal dysplasia and subsequent pregnancy outcomes.
MedLine Citation:
PMID:  23239538     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: We describe the sonographic features and pregnancy outcomes of placental mesenchymal dysplasia (PMD), an entity often misdiagnosed as molar pregnancy. Methods: We reviewed PMD cases from our institution and performed a systematic review of the existing literature. All cases described placental morphology by antenatal ultrasound. Results: We found 3 cases of PMD at our institution. Patient 1 had elevated HCG and an enlarged, hydropic placenta at 13 weeks, suspicious for a molar pregnancy. Patient 2 also had elevated HCG with large, vascular placental lakes on ultrasound suggesting placenta accreta versus molar pregnancy. Case 3 involved placentomegaly and an anomalous fetus suspicious for Beckwith-Wiedemann syndrome. From the literature review, 61 cases met inclusion criteria. The most common sonographic features included enlarged (50%) and cystic placenta (80%) with dilated chorionic vessels. Biochemical aneuploidy screening abnormalities were relatively common as were fetal anomalies, Beckwith-Wiedemann syndrome, and other genetic abnormalities. Pregnancy complications included intrauterine growth restriction (IUGR, 33%), intrauterine fetal demise (IUFD, 13%), and preterm labor (PTL, 33%). Pregnancies without fetal anomalies, IUGR, IUFD, or PTL had normal neonatal outcomes despite PMD (9%). Conclusions: The differential diagnosis of PMD includes molar pregnancy and other placental vascular anomalies. PMD is associated with adverse pregnancy outcomes, so heightened surveillance with genetic evaluation, serial growth scans, and 3(rd) trimester antenatal testing should be considered. PMD must be differentiated from gestational trophoblastic disease because management and outcomes differ. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Unzila A Nayeri; A Brian West; Holly K Grossetta Nardini; Joshua A Copel; Anna K Sfakianaki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-13
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynecology, SUNY Upstate Medical University, Syracuse, NY 13202. unzilanayeri@gmail.com.
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