1/303. Placental candidiasis: report of four cases, one with villitis. Four cases of placental candidiasis, an uncommon complication of rupture of the membranes, are presented. In addition to chorioamnionitis, in one of these cases villitis was also observed. Villitis is a rare occurrence in candida infection and this represents only the second case in the literature. The involvement of villi may be suggestive of blood-borne infection. However, since neither the mother nor the foetus presented any signs of systemic dissemination, the authors suggest a hypothesis of contamination of the villi from foci of chorioamnionitis. ( info) |
2/303. Focal aneurysmal dilatation of subchorionic vessels simulating chorioangioma. Subchorionic vascular aneurysms of the placenta are rare lesions and may present confusion with chorioangioma or focal mesenchymal dysplasia on sonography. To our knowledge, the findings of placental aneurysms have not been reported in the ultrasound literature. We present a case with detailed sonographic evaluation, including spectral and color Doppler and pathological analysis, that was mistaken for chorioangioma prenatally. knowledge of this benign entity may allow the sonologist to recommend conservative management in similar cases. ( info) |
3/303. A case of large placental chorioangioma with non-immunological hydrops fetalis. A 34-year-old Japanese woman (gravida 2, para 2) with polyhydramnios and non-immunological hydrops fetalis was referred to our department at 32 weeks of gestation. On admission, the blood pressure was 120/60 mmHg and there was no pitting edema of the lower extremities. An ultrasound examination disclosed a large placental tumor 5.8 cm x 4.4 cm x 4.8 cm. Fetal lung compression was suspected because the lung-thorax transverse area ratio was 0.13. The preload index of the inferior vena cava was 0.74, suggesting fetal cardiac failure. After fetal pleural effusion was aspirated, lung compression developed. cordocentesis was performed at 33 weeks of gestation, and the fetal karyotype was confirmed to be 46, XY from an umbilical blood cultivation. The patient underwent a cesarean section at 33 weeks of gestation due to severe uterine contraction after preterm PROM. The baby was a 3,840 g male with a distended abdomen. apgar score at 1 minute was 1. A chest X-ray demonstrated respiratory distress syndrome. The baby was discharged on the 69th day after birth and he is now 2 years and 9 months old and healthy. ( info) |
4/303. Villitis of known origin: varicella and toxoplasma. Chronic villitis is a common condition in human placentae. In some cases an infectious cause can be demonstrated, such as infection with cytomegalovirus and rubella virus. Most often it is of unknown aetiology, the so-called VUE (villitis of unknown aetiology). We describe two cases with identification of specific infectious agents, each demonstrating previously unreported findings, i.e. persistent varicella antigen in the villi in case 1, and presence of toxoplasma cysts in Wharton's jelly in case 2. The identification of the pathogens, varicella virus and toxoplasma, would easily have been overlooked in routine study of the placenta and were possible because of clinical suspicion. ( info) |
5/303. placenta percreta invading the bladder causing exsanguinating hemorrhage. We report a case of placenta percreta invading the urinary bladder that presented as gross hematuria. The patient had normal cystoscopic findings initially and other radiological investigations were reported as normal. However, she had catastrophic second hemorrhage and in spite of bilateral internal iliac artery ligation, hysterectomy and bladder closure with resuscitative measures, she could not be saved. ( info) |
6/303. Sonolucent areas in the placenta: sonographic and pathologic correlation. With the advent of gray scale ultrasonography, the internal structure of the placenta can be defined in great detail. Subchorionic sonolucent areas visualized on antepartum sonograms correlate with areas of subchorionic fibrin deposition, hematoma, and cystic degeneration in the term placenta. These lesions are apparently of no clinical significance. However, diffuse intraplacental sonolucent cystic lesions are abnormal and are seen in both hydatidiform mole and hydropic swelling of the placenta. ( info) |
7/303. Placental teratoma--a case report. A rare case of a mature placental teratoma in a 32-year-old woman is reported. We discuss the mechanism responsible for the development of this rare tumor in the placenta as well as the differential diagnostic difficulties encountered in fetus acardius amorphus, underlining the clinical significance of the exact diagnosis. ( info) |
8/303. Asymptomatic intraplacental choriocarcinoma diagnosed on routine placental examination. Asymptomatic intraplacental choriocarcinoma is a rare event with only a few case reports in the literature. The recognition of such a lesion on routine placental examination is important and prompts rapid clinical evaluation for identifying residual and/or metastatic disease followed by institution of chemotherapy. Failure to recognize such a lesion on gross inspection of the placenta can result in disseminated disease, which can be lethal. The following report describes the placental findings and clinical outcome in a recent case with a review of the relevant literature. ( info) |
| Two apparent acute problems that may occur in labor, nuchal cord and placental abruption, were associated with chorangiosis of the placenta. The importance of complete placental examination in perinatal mortality is re-emphasized. The association of apparent acute obstetrical conditions, e.g., nuchal cord and placental abruption with chorangiosis of the placenta, may be the cause of fetal-newborn deaths that were previously assumed to be issues of labor management. ( info) |
10/303. Placental pathology casebook. Serpentine aneurysms of the placenta with fetal consequences. Two cases of placental surface vessel aneurysms are presented. One case was associated with severe fetal intrauterine growth restriction and fetal thrombocytopenia. The other case was associated with "molar transformation" of placental villous tissue. ( info) |