Abstract

Background

Uterine leiomyomata have been loosely associated with intrauterine fetal demise (IUFD), largely attributed to fetal growth restriction from cavitary distortion. We present two cases of IUFD in patients with non-distorting leiomyomata and pathologic placental findings of maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM).

Case Report

Case 1 details a 28w3d IUFD associated with large leiomyomata (largest 11.9 × 7.6 × 9.7 cm), post-partum deep vein thrombosis, and severe pre-eclampsia histologic features. Case 2 details a 25w2d IUFD associated with smaller leiomyomata (largest 3.1 × 3.0 × 3.3 cm). Both placentas demonstrated MVM, including parenchymal thrombi and accelerated villous maturity, and FVM, including avascular stem villi.

Discussion

As the placentas in both cases demonstrated findings consistent with altered placental perfusion, we posit that leiomyomata in these cases may have been associated with both maternal and fetal vascular malperfusion, ultimately contributing to fetal demise.

中文翻译：

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血管灌注不良合并多发性子宫平滑肌瘤宫内死胎二例报告

摘要

背景

子宫平滑肌瘤与宫内胎儿死亡 (IUFD) 松散相关，主要归因于空腔畸变导致的胎儿生长受限。我们介绍了两例 IUFD 患者的非扭曲平滑肌瘤和母体血管灌注不良 (MVM) 和胎儿血管灌注不良 (FVM) 的病理胎盘发现。

案例报告

案例 1 详述了 28w3d IUFD 与大平滑肌瘤（最大 11.9 × 7.6 × 9.7 cm）、产后深静脉血栓形成和严重的先兆子痫组织学特征相关。案例 2 详述了与较小平滑肌瘤（最大 3.1 × 3.0 × 3.3 cm）相关的 25w2d IUFD。两个胎盘均显示 MVM，包括实质血栓和加速绒毛成熟，以及 FVM，包括无血管干绒毛。

讨论

由于这两个病例的胎盘都显示出与胎盘灌注改变一致的发现，我们假设这些病例中的平滑肌瘤可能与母体和胎儿的血管灌注不良有关，最终导致胎儿死亡。