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
ARTICLE HIGHLIGHTS
Case characteristics
A 23-year-old female patient at 32 wk of gestation was admitted for vaginal bleeding.
Clinical diagnosis
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).
Imaging diagnosis
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.
Pathological diagnosis
After caesarean, histological examination of placenta demonstrated the hypoechoic area was necrotic tissue.
Treatment
A caesarean surgery with placental exploration was performed.
Related reports
This is the first report of a rare case of placental necrosis with extremely elevated serum AFP.
Experiences and lessons
The combination of quantitative ultrasound imaging and AFP is valuable in assessing maternal-fetal interface lesion during pregnancy.
