Yu Weiming, Tellier Raymond, Wright James R
1 Department of Pathology & Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
2 Calgary Laboratory Services, Calgary, AB, Canada.
Pediatr Dev Pathol. 2015 Jul-Aug;18(4):331-4. doi: 10.2350/15-01-1603-CR.1. Epub 2015 Mar 31.
Massive perivillous fibrin deposition (MPFD) is an uncommon placental disorder, associated with significant fetal morbidity, mortality, and recurrence; its etiology is unknown. We describe a 31-year-old mother, diagnosed with Coxsackievirus infection and hand-foot-and-mouth disease at 35 weeks gestation. Ultrasound at 35 weeks revealed a normal fetus and placenta. One week later, the mother experienced decreased fetal movement and ultrasound demonstrated intrauterine demise. The autopsy showed mild, acute pericarditis and hypoxic-ischemic encephalopathy. Placenta examination showed MPFD involving 80% of the parenchyma. Molecular viral analysis and serotyping showed Coxsackie A16 virus. The mother had an uneventful pregnancy 15 months later. Coxsackievirus infections in pregnant mothers are often asymptomatic. Transplacental Coxsackievirus infection is very rare but is associated with spontaneous abortion, intrauterine demise, or serious neonatal morbidity. Mild, nonspecific histologic changes have been reported in the placenta. To our knowledge, this is the first report of MPFD associated with Coxsackievirus infection.
大面积绒毛周围纤维蛋白沉积（MPFD）是一种罕见的胎盘疾病，与显著的胎儿发病、死亡及复发相关；其病因不明。我们描述了一位31岁的母亲，在妊娠35周时被诊断为柯萨奇病毒感染和手足口病。35周时的超声检查显示胎儿和胎盘正常。一周后，母亲感觉到胎动减少，超声检查显示胎儿宫内死亡。尸检显示轻度急性心包炎和缺氧缺血性脑病。胎盘检查显示MPFD累及80%的实质。分子病毒分析和血清分型显示为柯萨奇A16病毒。15个月后，这位母亲再次妊娠，过程顺利。孕妇感染柯萨奇病毒通常无症状。经胎盘感染柯萨奇病毒非常罕见，但与自然流产、胎儿宫内死亡或严重的新生儿发病有关。胎盘曾有轻度、非特异性组织学改变的报道。据我们所知，这是第一例与柯萨奇病毒感染相关的MPFD报告。
