Gross Description -- Early Intrauterine Loss of Twin B


Received unfixed is a twin placenta with membranes. Dividing membranes are no longer grossly visible.

Placenta A: The eccentrically inserted cord is 3.0 cm from the nearest margin, 37 cm long, 1 cm in diameter and has three blood vessels. The marginally inserted membranes are complete and the point of rupture is 3.0 cm from the nearest margin. The fetal surfaces of the membranes are dull and pink-yellow. Within the membranes of disc A are the entrapped flattened twin B, umbilical cord of twin B and placenta of twin B. Disc A is oval, 19.0 by 13.5 by 1.5 cm, and weighs 420 grams. The fetal surface of the disc is dull, gray-blue and has several small subchorionic plaques, the largest of which measures 0.3 cm. These occupy less than 5 % of the total placental surface. There is a small subamniotic hemorrhage due to a needle puncture which measures 1.0 by 1.0 cm. The fetal vessels are engorged with fluid blood, contain no thrombi and measure between 2.0 and 12.0 cm in length. The maternal surface is slightly lacerated but complete and there is poor demarcation of the cotyledons. Sections show spongy red parenchyma. No focal lesions are identified.

Placenta B (contained within the membranes of Placenta A): An extremely flattened 5.0 cm cord exits from the disc margin. It extends to a flattened, tan-brown, soft, severely distorted fetus which measures 11.0 by 6.0 by 4.0 cm. The yellow, fibrotic and thin disc measures 12.0 by 12.0 by 2.0 cm and weighs 50 grams.





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