Maternal Floor Infarction/Massive Perivillous Fibrin Deposition Associated with Hypercoiling of a Single-Artery Umbilical Cord: A Case Report.
Maternal floor infarction is a rare and idiopathic placental disorder associated with adverse obstetric outcomes and a high rate of recurrence in subsequent pregnancies. The pathogenesis of maternal floor infarction is unclear but has been linked to diverse underlying maternal conditions, including gestational hypertension/preeclampsia, immune-mediated diseases, and thrombophilia. Few reports link maternal floor infarction to fetoplacental conditions. We report a 34-week, macerated, growth-restricted male fetus for which the placenta showed maternal floor infarction. The umbilical cord showed excessive coiling and a single umbilical artery. These cord changes are postulated to have resulted in increased placental villous resistance and decreased fetal blood flow, creating a hydrostatic pressure gradient between the villous stroma and the intervillous space. The pressure changes could then lead to trophoblast damage and fibrinoid deposition, contributing to the maternal floor infarction in this case.
1 Department of Pathology, Faculty of Medicine, Chulalongkorn University, 1873 King Rama IV Street, Pathumwan, Bangkok 10330, Thailand.
Mana
M
Taweevisit
1 Department of Pathology, Faculty of Medicine, Chulalongkorn University, 1873 King Rama IV Street, Pathumwan, Bangkok 10330, Thailand.|2 Department of Pathology and Laboratory Medicine, Hospital for Sick Children and University of Toronto, , Toronto, ON M5G1X8, Canada.
Paul Scott
PS
Thorner
D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D017809:Fatal Outcome; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000473:pathology*; D005337:Fibrin / Q000032:analysis*; D006801:Humans; D006874:Hydrostatic Pressure; D007238:Infarction / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D010920:Placenta / Q000098:blood supply* / Q000737:chemistry / Q000473:pathology*; D021041:Placental Circulation; D011247:Pregnancy; D058529:Single Umbilical Artery / Q000473:pathology* / Q000503:physiopathology
D005337:Fibrin
maternal floor infarction; placenta; single umbilical artery; umbilical cord hypercoiling