Sudden fetal death with placental mesenchymal dysplasia complicated by placenta previa

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Figure legends

Figure 1. Ultrasound and magnetic resonance imaging findings

(A, B) Ultrasound findings at 22+5/7 gestational weeks. (A) Transvaginal sonogram

showed that a placenta with multiple cysts covered the uterine cervix. (B) Abdominal

sonogram demonstrated two placentas, one was an enlarged placenta with multiple

vesicular lesions without blood flow (arrows) and another was a placenta appearing

normal (asterisk). (C, D) Magnetic resonance imaging (MRI) findings at 23+4/7

gestational weeks. (C) Sagittal, T2-weighted MRI showed an enlarged placenta with

multiple cysts. (D) Transverse, T2-weighted MRI indicated the presence of a normal

placenta (sharp sign) and an abnormal one (arrowheads).

Figure 2. Gross appearance of the placenta

(A) The fetal surface of the placenta. Dilated and tortuous vessels were observed (arrows).

(B) The maternal surface of the placenta consisted of grossly normal area (arrow heads)

and grossly abnormal area.

(C) The maternal surface of the placenta. Multiple grape-like vesicles were observed.

Figure 3. Pathological findings of the placenta

(A, B, and C) Hematoxylin and eosin stain; original magnification, 100x objective. (D)

Immunohistochemical staining for p57Kip2; original magnification, 400x objective.

(A) Enlarged hydropic stem villi, (B) no trophoblastic proliferation around the hydropic

stem villi with avascular stroma, and (C) hydropic stem villi with chorangioma-like

vascular proliferations were observed. (D) In immunohistochemical staining for p57Kip2,

positive staining in the villous cytotrophoblasts and no staining in the villous stroma were

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observed.

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