Two Morphologies in a Single Placenta With Placental Mesenchymal Dysplasia

An ultrasound investigation of a 28-year-old woman in the second trimester of her second pregnancy was suggestive of molar changes of placenta. Sonographically, the placenta had two distinct appearances - a normal portion and an area of heterogeneous appearance with a cystic area. It covered the internal os. There was a single live foetus. The management of this unique entity was marked by extensive workup of the differentials, testing and counselling. The pregnancy was continued, but antepartum haemorrhage resulted at 31 weeks, requiring an emergency cesarean delivery. Postpartum haemorrhage ensued, which required oxytocics and blood transfusion. Histopathology of the placenta was remarkable for features of placental mesenchymal dysplasia. The follow-up of the neonate and mother showed that they are doing well a year later. The diagnosis and management of this rare entity are discussed.