Extramembranous pregnancy: maternal, placental, and perinatal implications

The case of a patient who survived extramembranous pregnancy is presented, and the maternal, fetal, placental, and neonatal features of the condition are described and delineated. Previously underscribed phenomena include clinical evidence of fixed fetal position and a unique pattern of hemosiderin and hematoidin staining of the fetal membranes. The patient described had an intermediate form of the oligohydramnios tetrad following premature rupture of the membranes; the infant survived with respiratory support therapy in spite of apparent partial lung hypoplasia. On the basis of this and previous observations of the outcome of pregnancy complicated by prolonged amniotic fluid leakage, preliminary recommendations for the management of such pregnancies are made.