Published online Nov 6, 2018. doi: 10.12998/wjcc.v6.i13.675
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
A 23-year-old female patient at 32 wk of gestation was admitted for vaginal bleeding.
Central placenta previa with repeated intermittent vaginal bleeding.
Laboratory diagnosis
Laboratory investigations showed moderately elevated neutrophils and C-reactive protein as well as extremely elevated α-fetoprotein (AFP) (1032 ng/mL).
Ultrasonography revealed a heterogeneous and gradually enlarging hypoechoic area (reached 4.2 cm × 3.5 cm before labor) between the amniotic sac and the uterine myometrium.
After caesarean, histological examination of placenta demonstrated the hypoechoic area was necrotic tissue.
A caesarean surgery with placental exploration was performed.
This is the first report of a rare case of placental necrosis with extremely elevated serum AFP.
The combination of quantitative ultrasound imaging and AFP is valuable in assessing maternal-fetal interface lesion during pregnancy.