Skip to main content
Log in

Massive Perivillous Fibrinoid Degeneration of Placenta/ Maternal Floor Infarct: A Case Report

  • Case Report
  • Published:
Journal of Fetal Medicine

Abstract

Placental pathology can be a cause of early severe FGR leading to perinatal morbidity and mortality with repercussions in future pregnancies. A diagnosis of a placental lesion on ultrasound should have a detailed clinical and histopathological correlation for better management in next pregnancy. We present a case report of “placental massive perivillous fibrinoid degeneration/maternal floor infarction (MPFD)” with very large avascular placenta. This can lead to fetal growth restriction (FGR) and other complications for the fetus. It is also known to be associated with antiphospholipid syndrome. Management with low dose aspirin and low molecular weight heparin achieves good results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Al Sahan N, Gynspan D, Von Dadelszen P, Guslin A. Maternal floor infarction – Management of an unrecognised pathology. J Obst Gynecol Res. 2014;40:293–6.

    Article  Google Scholar 

  2. Benirschke K. Examination of placenta. Obst Gynecol. 1961;18:309–33.

    Google Scholar 

  3. Chen A, Roberts DJ. Placental pathologic lesions with a significant recurrence risk, What not to miss. J Pathol Microbiol Immunol. 2017;126:589–601.

    Google Scholar 

  4. Kulkarni AD, Palaniappan N, Evans MJ. Placental pathology and stillbirth, A review of the literature and guidelines for the less experienced. J Fetal Med. 2017;4:177–85.

    Article  Google Scholar 

  5. Dashe JS, Hoffman BL USG evaluation of the placenta, membranes and umbilical cord. Callen’s USG in OBGY, 6th edition 2017. P. 674–683.

  6. Romero R, Whitten A, Korzeniewski SJ, et al. Maternal floor infarction/massive perivillous fibrin deposition: a manifestation of maternal antifetal rejection? Am J Reprod Immunol. 2013;70:285–98.

    Article  CAS  Google Scholar 

  7. Andres RL, Kuyper W, Reshik R, Piacquadio KM, Benirschke K. The association of maternal floor infarction of the placenta with adverse perinatal outcome. Am J Obstet Gynecol. 1990;163:935–8.

    Article  CAS  Google Scholar 

  8. Katzman PJ, Genest DR. maternal floor infarction and massive perivillous fibrinoid degeneration—histological definitions, association with IUGR and risk of recurrence. Paed Dev Pathol. 2002;5:159–64.

    Article  Google Scholar 

  9. Gogia N, Machin GA. Maternal thrombophilias are associated with specific placental lesions. Pediatric Dev Pathol. 2008;11:424–9.

    Article  CAS  Google Scholar 

  10. Bane AL, Gillan JE. Massive perivillous fibrin deposition causing recurrent placental failure. BJOG. 2003;110:292–5.

    Article  CAS  Google Scholar 

  11. Benirschke K, Driscoll SG. maternal floor infarction—the Pathology of human placenta. New York: Springer Verlag; 1967. p. 328–30.

    Google Scholar 

  12. Sebire NJ, Backos M, Goldin RD, et al. Placental massive perivillous fibrinoid degeneration associated with antiphospholipid syndrome. BJOG. 2002;109:570–3.

    Article  CAS  Google Scholar 

  13. Redine RW, Jiang JG, Shah D. Discordancy for maternal floor infarction in dizygotic twin placentas. Hum Pathol. 2003;34:822–4.

    Article  Google Scholar 

  14. Makino A, Suzuki Y, Yamamoto T, Sato T, Kojima K. Use of aspirin and LMWH to prevent recurrence of maternal floor infarction in women without evidence of antiphospholipid anibody syndrome. Fetal Diagn Ther. 2004;19:261–5.

    Article  Google Scholar 

  15. Morreti SAF, Gruslin A, Grynspan D. Recurrent massive perivillous fibrinoid degeneration and chronic intervillositis treated with heparin and Intravenous immunoglobulin- a case report. J OBGY Can. 2017;39(8):676–81.

    Google Scholar 

  16. Kutteh WH, Hinote C. Antiphospholipid antibody syndrome. Obstet Gynecol Clin N Am. 2014;41:113–32.

    Article  Google Scholar 

  17. Chaiworapongsa T, Romero R, Korzeniewski S, Chaemsaithong P, Andrade EH. Provastatin to prevent recurrent fetal death in MPFD. J Matern Fetal Neonatal Med. 2016;29(6):855–62.

    Article  CAS  Google Scholar 

  18. Edison RJ, Muenke M. Mechanistic and epidemiologic consideration in the evaluation of adverse birth outcome following gestational exposure to statins. Am J Med Genet. 2004;131:1287–98.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Veena Mangesh Panat.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Panat, V.M. Massive Perivillous Fibrinoid Degeneration of Placenta/ Maternal Floor Infarct: A Case Report. J. Fetal Med. 8, 81–84 (2021). https://doi.org/10.1007/s40556-021-00290-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40556-021-00290-x

Keywords

Navigation