title: Fetal thrombotic vasculopathy in twin placentas with complete hydatidiform mole.
abstract: Complete hydatidiform mole with a coexistent normal twin is rare, but the mortality rate for the coexistent twin is high, usually attributed to preeclampsia or vaginal bleeding. Placental examination of 3 twin pregnancies complicated by complete hydatidiform mole revealed significant abnormalities in the fetal vasculature. In 1 case, an intrauterine demise at 27 weeks, the placenta showed chorionic plate vessels with mural fibrin thrombi. The placenta from a second case, delivered at 30 weeks for preterm labor, showed similar thrombi in chorionic plate vessels, accompanied by calcification. A third case delivered at 35 weeks produced a liveborn infant, and the placenta showed villous stromal-vascular karyorrhexis, avascular villi, and stem villous thrombosis. Fetal placental thrombotic lesions seen in the coexistent twin circulation, associated with a complete hydatidiform mole, may play a heretofore unrecognized role in the morbidity and mortality of the fetus.
authors.affiliation: The Children's Hospital of Philadelphia, Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, PA, USA. ernst@mail.chop.edu
authors.forename: Linda M
authors.initials: LM
authors.lastname: Ernst
authors.forename: Doris
authors.initials: D
authors.lastname: Chou
authors.forename: Samuel
authors.initials: S
authors.lastname: Parry
mesh_terms: D001808:Blood Vessels / Q000473:pathology; D005260:Female; D005333:Fetus; D006801:Humans; D006828:Hydatidiform Mole / Q000473:pathology*; D010920:Placenta / Q000098:blood supply* / Q000473:pathology; D010922:Placenta Diseases / Q000473:pathology*; D011247:Pregnancy; D013927:Thrombosis / Q000473:pathology*; D014427:Twins