Difference between revisions of "Maternal floor infarction"

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#redirect [[Placenta#Maternal floor infarction]]
'''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 infarct.
**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]]

Latest revision as of 02:30, 5 June 2015

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.[1]

General

  • Not a true infarct.
    • It is really fibrin deposition.[2]

Associations:

Gross

Features:[7]

  • +/-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.[7]
    • "Extensive" - either of the following:[4][8]
      1. Micro: one slide with >50% of villi involved.
        • Gross: full thickness involvement.
      2. Micro: maternal floor has at least 3 mm of fibrin on one slide.
        • Gross: maternal floor diffusely involved.

DDx:

Images

Sign out

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.

See also

References

  1. ↑ Baergen, Rebecca N. (2011). Manual of Pathology of the Human Placenta (2nd ed.). Springer. pp. 367. ISBN 978-1441974938.
  2. ↑ Weedman Molavi, Diana (2008). The Practice of Surgical Pathology: A Beginner's Guide to the Diagnostic Process (1st ed.). Springer. pp. 178. ISBN 978-0387744858.
  3. ↑ Roberts, DJ.; Post, MD. (Dec 2008). "The placenta in pre-eclampsia and intrauterine growth restriction.". J Clin Pathol 61 (12): 1254-60. doi:10.1136/jcp.2008.055236. PMID 18641412.
  4. ↑ 4.0 4.1 Katzman, PJ.; Genest, DR.. "Maternal floor infarction and massive perivillous fibrin deposition: histological definitions, association with intrauterine fetal growth restriction, and risk of recurrence.". Pediatr Dev Pathol 5 (2): 159-64. doi:10.1007/s10024-001-0195-y. PMID 11910510.
  5. ↑ 5.0 5.1 Sebire NJ, Backos M, Goldin RD, Regan L (May 2002). "Placental massive perivillous fibrin deposition associated with antiphospholipid antibody syndrome". BJOG 109 (5): 570–3. PMID 12066949. http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1470-0328&date=2002&volume=109&issue=5&spage=570.
  6. ↑ Kanfer, A.; Bruch, JF.; Nguyen, G.; He, CJ.; Delarue, F.; Flahault, A.; Nessmann, C.; Uzan, S. (Jan 1996). "Increased placental antifibrinolytic potential and fibrin deposits in pregnancy-induced hypertension and preeclampsia.". Lab Invest 74 (1): 253-8. PMID 8569189.
  7. ↑ 7.0 7.1 Baergen, Rebecca N. (2011). Manual of Pathology of the Human Placenta (2nd ed.). Springer. pp. 368. ISBN 978-1441974938.
  8. ↑ AFIP - Placental Pathology. P.135. ISBN: 1-881041-89-1. 2004.
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