Looks Can Be Deceiving: A Case of Placental Mesenchymal Dysplasia with Concomitant Cytomegalovirus Infection
Mona Rae P. Evangelista, MD; Gumersinda Cruz-Javier, MD, FPOGS
Department of Obstetrics and Gynecology, The Medical City
Pregnancy with placental mesenchymal dysplasia (PMD), with concomitant cytomegalovirus (CMV) infection, and with coexistent normal viable fetus is very rare. An 18 year old, Gravida 2 Para 0 (0-0-1-0), was referred to our institution at 24 weeks age of gestation, with impression of molar pregnancy with a live twin fetus. Subsequent ultrasound revealed placentomegaly with placental features similar to hydatidiform mole. Her pregnancy was complicated with intrauterine growth restriction (IUGR) and oligohydramnios. TORCH panel at 25 weeks age of gestation revealed positive for CMV IgG. She had normal serum ?-HCG, with elevated maternal serum alpha feto protein (msAFP). A caesarean section was done at 37 weeks age of gestation for placenta previa marginalis in haemorrhage. She delivered a live baby girl, APGAR score of 9,9, maturity testing of 37 weeks, small for gestational age. The baby was also positive for CMV IgG. Gross examination of the placenta revealed tortuous vessels and multiple cystic spaces. Histopathologically, there were hydropic stem villi with no trophoblastic proliferation. Immunohistochemically, placental mesenchymal dyspla-
sia was confirmed.