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Ann, Kim, Cho, Shim, Kim, Bae, and Yang: A case of stillbirth due to extensive infarction in the basal layer of the placenta diagnosed by prenatal ultrasonography
Case Report
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(1): 49-52.

Published online: 31 January 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.1.49

A case of stillbirth due to extensive infarction in the basal layer of the placenta diagnosed by prenatal ultrasonography

Chi-Ok Ann, MD1, Shi-Sun Kim, MD1, Eun-Kyu Cho, MD1, Hyun-Jin Shim, MD1, Yun-Sook Kim, MD1, Dong-Han Bae, MD1, Seoung-Ha Yang, MD2

1Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

2Department of Pathology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

Corresponding author: Yun-Sook Kim, MD. Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, 23-20 Bongmyeong-dong, Dongnam-gu, Cheonan 330-721, Korea. Tel: +82-41-570-2150, Fax: +82-41-571-7887, drsook@schmc.ac.kr

Received 17 September 2010       Revised 16 October 2010       Accepted 10 December 2010

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Placental infarction is a localized area of ischemic villous necrosis, resulting from interruption in maternal blood supply. These have been associated with postterm pregnancies, maternal hypertension, and anticardiolipin antibodies. Most are due to thrombotic occlusion of an uteroplacental artery. But, infarction in the basal layer of the placenta is very rare and characterized histologically by massive deposition of fibrin. The etiology remains uncertain. However, it has clearly associated with significant perinatal morbidity and mortality including stillbirth, preterm birth, and intrauterine growth restriction. This condition has been diagnosed by prenatal ultrasonography with hyperechoic areas along the maternal side, but extending through much of the placental tissue. Recently we have experienced a case of extensive infarction in the basal layer of the placenta diagnosed by prenatal ultrasonography at 17 weeks, resulted in stillbirth. We describe this case with a brief review of the literature.

Keywords: Infarction in the basal layer of the placenta, Stillbirth

Figures and Tables

Fig. 1
Transabdominal sonogram showed an abnormally thick and 76×33 mm sized hypoechoic areas along the basal layer of placenta, but extending through much of the placental tissue.
kjog-54-49-g001
Fig. 2
Gross placental specimen revealing basal layer massive placental infarction in basal layer with yellowish material representing excessive fibrin deposition.
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Fig. 3
The cut surface of placenta showed massive infarction in basal layer and excessive fibrin deposition (H&E, ×100).
kjog-54-49-g003

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