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Difference between revisions of "Maternal floor infarction"
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'''Maternal floor infarction''', abbreviated ''MFI'', is a pathology of the [[placenta]]. | |||
It is formally known as ''placental maternal floor infarction''. It is also known as '''massive perivillous fibrin deposition'''.<ref name=Ref_Placenta367>{{Ref Placenta|367}}</ref> | |||
==General== | |||
*'''''Not''''' a true infact. | |||
**It is really fibrin deposition.<ref name=Ref_TPoSP178>{{Ref TPoSP|178}}</ref> | |||
Associations: | |||
*[[Intrauterine growth restriction]] (IUGR).<ref name=pmid18641412>{{Cite journal | last1 = Roberts | first1 = DJ. | last2 = Post | first2 = MD. | title = The placenta in pre-eclampsia and intrauterine growth restriction. | journal = J Clin Pathol | volume = 61 | issue = 12 | pages = 1254-60 | month = Dec | year = 2008 | doi = 10.1136/jcp.2008.055236 | PMID = 18641412 }}</ref><ref name=pmid11910510>{{Cite journal | last1 = Katzman | first1 = PJ. | last2 = Genest | first2 = DR. | title = Maternal floor infarction and massive perivillous fibrin deposition: histological definitions, association with intrauterine fetal growth restriction, and risk of recurrence. | journal = Pediatr Dev Pathol | volume = 5 | issue = 2 | pages = 159-64 | month = | year = | doi = 10.1007/s10024-001-0195-y | PMID = 11910510 }}</ref> | |||
*Anti-phospholipid antibody (APLA) syndrome.<ref name=pmid12066949>{{cite journal |author=Sebire NJ, Backos M, Goldin RD, Regan L |title=Placental massive perivillous fibrin deposition associated with antiphospholipid antibody syndrome |journal=BJOG |volume=109 |issue=5 |pages=570–3 |year=2002 |month=May |pmid=12066949 |doi= |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1470-0328&date=2002&volume=109&issue=5&spage=570}}</ref> | |||
**APLA is associated with recurrent miscarriage - can be treated with heparin + ASA.<ref name=pmid12066949/> | |||
*Pregnancy-induced [[hypertension]].<ref name=pmid8569189>{{Cite journal | last1 = Kanfer | first1 = A. | last2 = Bruch | first2 = JF. | last3 = Nguyen | first3 = G. | last4 = He | first4 = CJ. | last5 = Delarue | first5 = F. | last6 = Flahault | first6 = A. | last7 = Nessmann | first7 = C. | last8 = Uzan | first8 = S. | title = Increased placental antifibrinolytic potential and fibrin deposits in pregnancy-induced hypertension and preeclampsia. | journal = Lab Invest | volume = 74 | issue = 1 | pages = 253-8 | month = Jan | year = 1996 | doi = | PMID = 8569189 }}</ref> | |||
==Gross== | |||
Features:<ref name=Ref_Placenta368>{{Ref Placenta|368}}</ref> | |||
*+/-Thickened placenta. | |||
*Maternal aspect of placental disc irregular or lobulated appearance. | |||
*+/-Yellowish discolourization. | |||
==Microscopic== | |||
Features: | |||
*Extensive fibrin deposition around villi on maternal aspect - see: ''[[Perivillous fibrin deposition]]''. | |||
**Described as having a "net-like" pattern.<ref name=Ref_Placenta368>{{Ref Placenta|368}}</ref> | |||
**"Extensive" - either of the following:<ref name=pmid11910510/><ref>AFIP - Placental Pathology. P.135. ISBN: 1-881041-89-1. 2004.</ref> | |||
**#Micro: one slide with >50% of villi involved. | |||
**#*Gross: full thickness involvement. | |||
**#Micro: maternal floor has at least 3 mm of fibrin on one slide. | |||
**#*Gross: maternal floor diffusely involved. | |||
DDx: | |||
*[[Perivillous fibrin deposition]] - less perivillous fibrin. | |||
*[[Placental infarction]]. | |||
Images: | |||
*[http://www.flickr.com/photos/jian-hua_qiao_md/3987724630/ Maternal floor infarct (flickr.com)]. | |||
*[http://www.flickr.com/photos/jian-hua_qiao_md/3986970923/ Maternal floor infarct (flickr.com)]. | |||
*[http://path.upmc.edu/cases/case224.html Maternal floor infarct - several images (upmc.edu)]. | |||
==Sign out== | |||
<pre> | |||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: | |||
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | |||
- FETAL MEMBRANES WITHIN NORMAL LIMITS. | |||
- SMALL PLACENTAL DISC WITH MASSIVE PERIVILLOUS FIBRIN DEPOSITION, SEE COMMENT. | |||
COMMENT: | |||
Massive perivillous fibrin deposition (MPVFD) is associated with intrauterine | |||
growth restriction (IUGR). MPVFD is described in association with in | |||
anti-phospholipid antibody (APLA) syndrome, pregnancy-induced hypertension and | |||
congenital infections. Perivillous fibrin deposition may be seen in diabetes. | |||
There is no apparent infection. Changes suggestive of decidual vasculopathy | |||
are not apparent. Changes suggestive of fetal thrombotic vasculopathy are | |||
not identified. | |||
</pre> | |||
==See also== | |||
*[[Placenta]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Placenta]] | |||