Clinical manifestations of placental mesenchymal dysplasia in Japan: A multicenter case series.
fetal demise
fetal growth restriction
hypertensive disorder of pregnancy
maternal serum alpha-fetoprotein levels
placental mesenchymal dysplasia
Journal
The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Titre abrégé: J Obstet Gynaecol Res
Pays: Australia
ID NLM: 9612761
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
06
11
2020
revised:
15
12
2020
accepted:
22
12
2020
pubmed:
20
1
2021
medline:
22
6
2021
entrez:
19
1
2021
Statut:
ppublish
Résumé
This study aimed to evaluate the clinical features and pregnancy outcomes of placental mesenchymal dysplasia (PMD) in Japan. We requested detailed clinical information and placental tissue of PMD cases in 2000-2018 from Japanese facilities with departments of obstetrics and gynecology and analyzed the pregnancy course and neonatal outcomes. We collected 49 cases of PMD. Of 18 patients with measured maternal serum alpha-fetoprotein (MSAFP) levels, 15 (83.3%) had elevated levels. Maternal serum human chorionic gonadotropin (MShCG) levels were transiently elevated in five (17.8%) of 28 patients. Forty-seven patients continued their pregnancies. All pregnancies were singleton and 40 (85.1%) were associated with adverse events including fetal growth restriction (FGR), threatened premature delivery, fetal demise, and hypertensive disorder of pregnancy in 34 (72.3%), 14 (29.8%), eight (17.0%), and six (12.8%) patients, respectively. Of 47 infants, there were eight stillbirths. There were 40 (85.1%) female infants, and eight (17.0%) had Beckwith-Wiedemann syndrome. Of 39 live births, 23 (59.0%) were associated with premature induction of labor or cesarean section for obstetric indications related to FGR. Eighteen (46.2%) neonates had complications. PMD-affected placentas were pathologically heterogeneous in both grossly PMD-affected and non-affected areas. Our study included the largest number of PMD cases with detailed clinical information. PMD is a high-risk condition for both the mother and the child. Elevated MSAFP levels with normal MShCG levels indicate PMD. Conventional perinatal management of FGR in Japan might be effective in reducing the fetal mortality rate.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1118-1125Subventions
Organisme : a grant for research on intractable diseases from the Ministry of Health, Labour and Welfare of Japan
ID : H24-Nanchi-Ippan-077
Organisme : Japan Society for the Promotion of Science
ID : JP15K10678
Informations de copyright
© 2021 Japan Society of Obstetrics and Gynecology.
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