An interesting pathological specimen at deliveryBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a2453 (Published 13 November 2008) Cite this as: BMJ 2008;337:a2453
- Roshen Mathew, clinical preceptor1,
- K S Shakuntala Devi, professor and head of department2,
- Ganesh Rao, assistant professor2,
- Sheju Thomas, resident2
- 1Department of General Medicine and Family Practice, Sree Siddhartha Medical College, Tumkur, India
- 2Department of Obstetrics and Gynaecology, Sree Siddhartha Medical College, Tumkur, India
A 26 year old gravida 2 para 1 woman presented in the third trimester of her pregnancy. She had not had antenatal check ups, but was in good health. She had attended a first trimester scan, and said that the doctor told her she was having twins. She had a family history of twins. Her first pregnancy had resulted in a full term normal vaginal delivery.
Routine antenatal checks all were normal. Ultrasonography showed a normally growing fetus, appropriate for dates, and a cystic flattened mass near the placenta. No blood flow to the cystic mass could be seen.
At term she delivered a 3200 g male infant by normal vaginal delivery. After the delivery, a pathological specimen was delivered along with the remnants of the placenta. The placenta showed a calcified and nodular area on the fetal surface. Microscopic examination of the placenta showed nests of epithelioid cells and deposits of fibrin. There were no postpartum complications.⇓
1 What is the pathological specimen in the photograph?
2 What are the possible complications of the condition to the mother and fetus?
3 On the basis of the results of ultrasonography, what differential diagnosis would …