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Combined Placental Maternal Floor Infarction and Cytomegalovirus Placentitis: A Case Report

Mana Taweevisit1, Montakarn Tansatit2, Piriya Sutthiruangwong3

  • 1Pathology, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand.

Fetal and Pediatric Pathology
|December 9, 2020
PubMed

BackgroundMaternal floor infarction (MFI) and massive perivillous fibrin deposition (MPFD) are uncommon, related placental conditions secondary to trophoblastic cell damage. The etiology is unknown but MPFD/MFI is associated with adverse obstetric outcome and a significant risk of recurrence. Case report: We report a case of MPFD/MFI associated with cytomegalovirus (CMV) placentitis. A 27-year-old mother delivered a stillborn male fetus with a postmortem diagnosis of congenital CMV. The placenta showed a lymphohistiocytic villitis with isolated CMV inclusions, in combination with MFI. The villitis had features intermediate between CMV placentitis and villitis of unknown etiology (VUE). Conclusion: VUE is considered to be a maternal anti-fetal immune reaction resembling allograft rejection. We postulate that the viral infection in our case may have triggered this immune response, given that CMV antigens are known to cross react with some human antigens, in particular HLA. The subsequent trophoblastic cell damage could then lead to MFI/MFPD.

Keywords:
Maternal floor infarctioncytomegalovirusmassive perivillous fibrin depositionvillitis of unknown etiology

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