Yu MY, Xi L, Zhang JX, Zhang SC. Possible connection between elevated serum α-fetoprotein and placental necrosis during pregnancy: A case report and review of literature. World J Clin Cases 2018; 6(13): 675-678 [PMID: 30430124 DOI: 10.12998/wjcc.v6.i13.675]
Corresponding Author of This Article
Shi-Chang Zhang, MD, PhD, Assistant Professor, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing 210029, Jiangsu Province, China. zsc78@yeah.net
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2018; 6(13): 675-678 Published online Nov 6, 2018. doi: 10.12998/wjcc.v6.i13.675
Possible connection between elevated serum α-fetoprotein and placental necrosis during pregnancy: A case report and review of literature
Meng-Yao Yu, Lei Xi, Jie-Xin Zhang, Shi-Chang Zhang
Meng-Yao Yu, Jie-Xin Zhang, Shi-Chang Zhang, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Lei Xi, Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Yu MY and Xi L participated in data collection; Zhang JX and Zhang SC conceived and coordinated the study; all authors participated in manuscript writing.
Supported byNational Natural Science Foundation of China, Nos. 81501817 and 81671836; Natural Science Youth Foundation of Jiangsu Province, No. BK20151029; and the Key Laboratory for Laboratory Medicine of Jiangsu Province of China, No. ZDXKB2016005.
Informed consent statement: Informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.
Open-Access: This article is an open-access article, which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shi-Chang Zhang, MD, PhD, Assistant Professor, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing 210029, Jiangsu Province, China. zsc78@yeah.net
Telephone: +86-25-68103450
Received: July 31, 2018 Peer-review started: July 31, 2018 First decision: August 20, 2018 Revised: August 23, 2018 Accepted: August 28, 2018 Article in press: August 28, 2018 Published online: November 6, 2018 Processing time: 99 Days and 4 Hours
Abstract
Placenta previa is the main cause of bleeding throughout pregnancy, and it is associated with serious complications, such as infection, that lead to a poor prognosis. Gynecological sonography is recommended as the first-line examination technique for the surveillance and determination of vaginal bleeding and for early intervention. We report the case of a patient with gradually expanded hypoechoic lesion and extremely high serum α-fetoprotein level during her third trimester, and discuss their potential relationship in evaluating the progression of placental necrosis.
Core tip: Placental necrosis with extremely high maternal serum α-fetoprotein (AFP) is rare. We reported a 23-year-old female patient with central placenta previa suffered from repeated vaginal bleeding. Follow-up ultrasonography revealed a gradually enlarging hypoecho between the amniotic sac and the uterine myometrium. Until 32 wk of gestation, laboratory results showed extremely elevated maternal serum AFP. Both intraoperative exploration of the placenta and histological examination demonstrated the hypoechoic area was necrotic tissue. To our knowledge, this is the first report of a rare case of extreme AFP level in placental necrosis. Clinicians should consider the combination usage of quantitative ultrasound imaging and AFP as a practical tool for assessing placental lesions.
