Case 224 -- A Stillborn Fetus with a Placental Abnormality

Contributed by Ryan McCune, MD and Edward C. Klatt, MD,
      Department of Pathology, University of Utah Health Sciences Center
Published on line in March 2000


The fetus was the stillborn product of a gestation estimated to be 29 weeks. The mother was a 29 year old Hispanic, gravida 4 para 3 abortus 0. Her previous pregnancies had resulted in one term, two premature, and no stillborn babies. Prenatal ultrasound was performed at 23.6 weeks and showed no anomalies. The mother reported absence of fetal movement three days before delivery. There was no maternal history of diabetes mellitus, tobacco use, or alcohol use. Pregnancy was not complicated by hypertension. There was no clinical evidence for placental abruption or placenta previa. Premature rupture of membranes had not occurred. A normal vaginal delivery was induced with Prostin after confirmation of fetal demise. At birth, the baby was not meconium stained and no fetal anomalies were noted.


The moderately macerated fetus weighed 731 gm and had morphometric measurements consistent with 28 to 29 weeks gestations. The discoid placenta weighed 236 gms after the free membranes and cords were dissected off and measured 13.0 x 12.0 x 2.5 cm. A two vessel umbilical cord was 40.5 cm long and 1.5 cm in diameter, narrowing to 0.5 cm at its insertion, and shows a paracentral insertion. The fetal membranes were thin and translucent. The gross appearances of the fetal surface, maternal surface, and cut surface of the placenta are shown above.


A low power view of the placenta is shown above. The amnion and chorion were unremarkable. The umbilical cord showed a single umbilical artery and a vein. No inflammation was present in the placenta, cord, or membranes.



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