Browsing by Author "Kalavathy Ramachandram"
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Publication Maternal Floor Infarction: An old entity yet a finding not to be missed(College of Pathologists, Academy of Medicine Malaysia, 2015-06) ;Nur Syahrina Rahim ;Nazifah Adznan ;Kalavathy Ramachandram ;Vickneswaran Ramasamy ;Valyakalayil Daniel PhilipAbd Rahman HayatiIntroduction: Maternal Floor Infarction (MFI) is an uncommon pathological entity characterised by the presence of massive and diffuse perivillous fibrinoid material in the maternal surface of the placenta. It was first described in the 1960s. MFI has clear associations with intrauterine fetal demise, IUGR and recurrent pregnancy losses. We would like to share two cases of MFI, which had similar clinical presentations. Case reports: Case 1: A 31-year-old lady who is in her sixth pregnancy and at 32 weeks of gestation. She has a history of three intrauterine fetal deaths and two live births. Her recent pregnancy was complicated with IUGR, oligohydramnious and absence of end diastolic flow on Doppler. Case 2: A 34-year-old lady who is in her third pregnancy and at 35 weeks of gestation. Similarly she had IUGR and oligohydramnios. In both cases, the babies were delivered alive by caesarean sections. Tissue examination of both placentas showed extensive fibrin deposition on the decidual floor, extending up into the intervillous spaces with encasement of the villi amounting to MFI. Discussion and Conclusion: Although MFI is uncommon, it has significant perinatal morbidity and mortality with the risk of recurrence. In general, practicing pathologists are unfamiliar with MFI which is macroscopically and microscopically different from ischaemic infarcts. The etiology of MFI is unknown, but evidence support an alloimmune or autoimmune mechanism. Awareness of this old entity and recognizing them on placenta tissue sections would aid in management of future pregnancies and in the adequate follow up of the surviving infants