Key result
Untreated maternal syphilis was associated with massive perivillous fibrin deposition on placental examination, expanding the known etiologies of this uncommon placental disorder.
Why the study?
Massive perivillous fibrin deposition and maternal floor infarction are uncommon placental disorders of unknown etiology associated with adverse obstetric outcomes.
Case Report (n=1)
This case report identifies placental syphilis as a potential etiology for massive perivillous fibrin deposition (MPFD).
MPFD may occur with untreated maternal syphilis; this case report leaves open any causal link or recurrence implications.
Massive perivillous fibrin deposition (MPFD) and the related entity of maternal floor infarction (MFI) are uncommon placental disorders of unknown etiology, associated with adverse obstetric outcome and a significant risk of recurrence. We describe a 19-year-old mother with untreated syphilis who delivered a male neonate with low birth weight, skin desquamation, and pneumonia. Placenta examination showed the expected changes for syphilis but unexpectedly, also showed MPFD. To our knowledge, this is the first report of MPFD associated with placental syphilis, thus expanding the list of etiologies that may be related to MPFD/MFI. It is postulated that the syphilis infection in our case led to a hypercoaguable state, eventually resulting in MPFD. In the right clinical setting, syphilis might be considered in the differential diagnosis when MPFD/MFI is observed on placental examination. The recurrence risk of MFPD/MFI associated with infections is believed to be lower than idiopathic cases and, by extrapolation, this lower risk should apply to syphilis as well.
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Taweevisit et al. (2020) conducted a case report in Massive perivillous fibrin deposition and placental syphilis (n=1). Untreated syphilis was evaluated on Massive perivillous fibrin deposition on placental examination. Untreated maternal syphilis was associated with massive perivillous fibrin deposition on placental examination, expanding the known etiologies of this uncommon placental disorder.
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