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Three‐Dimensional Sonography of Placental Mesenchymal Dysplasia and Its Differential Diagnosis
Author(s) -
Vaisbuch Edi,
Romero Roberto,
Kusanovic Juan Pedro,
Erez Offer,
Mazaki-Tovi Shali,
Gotsch Francesca,
Kim Chong Jai,
Kim Jung-Sun,
Yeo Lami,
Hassan Sonia S.
Publication year - 2009
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2009.28.3.359
Subject(s) - medicine , placenta , gestation , single umbilical artery , fetus , differential diagnosis , placenta diseases , lesion , pathology , obstetrics , pregnancy , radiology , genetics , biology
Objective. Placental mesenchymal dysplasia (PMD) is an uncommon vascular anomaly of the placenta characterized by mesenchymal stem villous hyperplasia. Its main sonographic feature is a thickened placenta with hypoechoic areas, and an accurate sonographic diagnosis is challenging. The aim of this study was to report 2 cases of PMD and discuss the differential diagnosis of its sonographic features. Methods. Cases of placental masses were studied by 2‐dimensional (2D), 3‐dimensional (3D), and color Doppler imaging. Results. In case 1, a thick placenta with multiple hypoechoic areas was noted at 13 weeks' gestation. At 19 weeks, the multicystic area, clearly demarcated from a normal‐looking placenta, measured 6.5 × 8.5 cm and enlarged gradually. The patient gave birth to a 625‐g female neonate after spontaneous labor at almost 26 weeks' gestation. In case 2, a first sonographic examination at 25 weeks' gestation revealed a thickened placenta with hypoechoic areas and a fetus with a single umbilical artery and a ventricular septal defect. At 27 weeks, the abnormal area of the placenta measured 14.5 × 7.5 cm. At 32 weeks' gestation, a caesarean delivery was performed because of a nonreassuring fetal heart tracing, and a 1415‐g female neonate was delivered. Both cases were evaluated by 2D, 3D, and color Doppler imaging, and the pathologic features of both placentas were consistent with PMD. Conclusions. Placental mesenchymal dysplasia should be considered in the differential diagnosis of every placental mass, especially in cases of multicystic placental lesion with lack of high‐velocity signals inside the lesion, and a normal karyotype.