Microstructural observations of villous and membrane histology in monochorionic triplet placenta after in vitro fertilization.
The frequency of triplet gestation is low in humans, estimated at 1:6400 deliveries. Monochorionic gestations represent a subpopulation of approximately 10% of these triplet pregnancies. Hypertensive complications are known to occur with greater frequency in the context of multiple gestation. In this report we describe microscopic placental changes associated with pre-eclampsia and proteinuria in the setting of an uncommon monochorionic-triamniotic triplet pregnancy achieved via in vitro fertilization. Histologic features observed in this case include placental stromal fibrosis and increased syncytial nodularity (Tenney-Parker change). In this triplet delivery resulting from two consecutive fissions of a single embryo, chorion and amnion configuration are also characterized with a review of the literature discussing the potential relationship between in vitro culture conditions and monozygotic multiple gestation.
Sills
E S
ES
Georgia Reproductive Specialists, Atlanta, Georgia, USA. dr.sills@ivf.com
Ghulmiyyah
L M
LM
Wehbe
S A
SA
Atkinson
P F
PF
Perloe
M
M
Tucker
M J
MJ
D000328:Adult; D002823:Chorion / Q000033:anatomy & histology*; D002824:Chorionic Villi / Q000033:anatomy & histology; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010920:Placenta / Q000033:anatomy & histology*; D011225:Pre-Eclampsia / Q000209:etiology / Q000473:pathology; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011507:Proteinuria / Q000209:etiology / Q000473:pathology; D014310:Triplets