Placental mesenchymal dysplasia associated with spontaneous ovarian hyperstimulation syndrome.
Placental mesenchymal dysplasia (PMD) is a rare disorder of unknown aetiology characterised by placentomegaly, serpiginous surface blood vessels and large cystic villi. Although a mimic of molar pregnancies and other entities, it can be distinguished from them by its association with intrauterine growth restriction or death of a relatively normal fetus and its characteristic histopathology. We report the case of a 20-year-old primigravida who presented at 16 weeks with heavy clotty vaginal bleeding and subsequent miscarriage. The placenta was grossly abnormal and resembled a partial molar pregnancy. PMD was confirmed by microscopic examination. Postmiscarriage, ultrasound revealed enlarged and multicystic ovaries similar to those seen in ovarian hyperstimulation syndrome (OHSS), which returned to normal a few weeks after miscarriage. This is the first report of PMD associated with OHSS, and we hypothesise that the most likely pathogenesis is ovarian stimulation from PMD-derived vascular endothelial growth factor.
Department of Obs & Gynae, South West Acute Hospital, Enniskillen, UK.
Payam
P
Davoudian
D000022:Abortion, Spontaneous / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D010922:Placenta Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011247:Pregnancy; D014463:Ultrasonography; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D055815:Young Adult
D042461:Vascular Endothelial Growth Factor A