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Placental Mesenchymal Dysplasia Presenting as a Twin Gestation With Complete Molar Pregnancy

Starikov, Roman MD; Goldman, Randi MD; Dizon, Don S. MD; Kostadinov, Stefan MD; Carr, Stephen MD

doi: 10.1097/AOG.0b013e3182161828
Case Reports
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BACKGROUND: Placental mesenchymal dysplasia is a rare abnormality characterized by placentomegaly, grapelike cystic vesicles, and villous hyperplasia. The clinical and ultrasonographic presentation may mimic molar pregnancy, provoking incorrect diagnoses and unnecessary therapeutic interventions.

CASE: A 36-year-old nulliparous woman presented for prenatal ultrasonography that indicated the presence of one gestational sac containing both fetus and cystic mass, concerning for partial molar pregnancy. Amniocentesis returned a 46,XX karyotype, suggesting a twin gestation with complete mole. The patient was monitored closely and, because of fetal growth restriction, was induced successfully at term and delivered a healthy newborn. Histopathologic findings of the placenta were consistent with placental mesenchymal dysplasia.

CONCLUSION: Although placental mesenchymal dysplasia is often confused with molar pregnancy, it is important to consider both in a differential to avoid inappropriate treatments.

Placental mesenchymal dysplasia often is confused with molar pregnancy.

From the Division of Maternal–Fetal Medicine, the Program in Women's Oncology, and the Department of Pathology, Women & Infants Hospital, Providence, Rhode Island; the Departments of Obstetrics-Gynecology and Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; and Albany Medical College, Albany, New York.

Corresponding author: Roman Starikov, MD, Women & Infants Hospital of Rhode Island, 101 Dudley Street, MFM 3rd Floor, Providence, RI 02905; e-mail: rstarikov@wihri.org.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists