Outcome and follow-up
The team decided to induce the labor at 35 weeks and 2 days, by vaginal
prostin E2 tablets. Labour was uncomplicated and a healthy girl of 2160
g and 46 cm, Apgar score 8-9-10, born the day after. The placenta was
delivered spontaneously.
The female infant was admitted to the neonatal unit due to induced
prematurity.
The adaptation to extrauterine life went smoothly. A transitory
hypoglycemia was noted as well as a neonatal jaundice requiring
phototherapy. No anemia and no thrombocytopenia were detected.
The placenta was sent for pathological examination. The macroscopic
report found the placenta to be enlarged and thickened, weighing 530g
(90th percentile). Near cord insertion on the fetal surface, vessels
were dilated, tortuous with varicose like aspect and abnormal branching
(Figure 3, left). A fibrinoid deposition was found on one third of the
maternal surface. On the cut sections, organized thrombi were found in
the macroscopically dilated vessels that also exhibited a
microscopically thickened wall. Histological examination found enlarged
villi with cisterns with hypercellularity and stromal fibrosis (Figure
3, right). No trophoblastic proliferation nor stromal trophoblastic
inclusions were found. Therefore, a PMD diagnosis was established with
certainty after pathologic examination. Additionally, only a limited
portion of the placenta did not exhibit any histological abnormality,
showing typical aged matched terminal villi.