The placenta findings from an XYY abortus: a case report
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CASE REPORT
JOURNAL OF MEDICAL
CASE REPORTS Open Access
The placenta findings from an XYY abortus: a case report Rong Fan
Abstract Introduction: The placenta morphology from an XYY pregnancy abortus has not been reported in the medical literature. This case report consists of the first detailed documentation. The reported case is also highly unusual because the mother had two prior pregnancies with fetuses being confirmed to have Zellweger syndrome and one prior molar pregnancy. Case presentation: A 43-year-old Caucasian woman presented for induction of labor secondary to diagnosis of XYY chromosomes by chorionic villus sample. Conclusions: This is the first detailed observation of placenta morphology in an XYY abortus. Although not highly specific, the observation is very unique and should prompt further investigation of karyotyping of the fetus or infant because an XYY individual may be viable and grow to adulthood. The association of an XYY abortus and prior pregnancies with Zellweger syndrome and one prior molar pregnancy is also highly notable.
Introduction XYY syndrome is well known and well reported in the medical literature, but its placenta morphology has not been specifically described in the past. We report a case of two Zellweger syndrome fetuses, one molar and one XYY, from a single mother. This is highly unusual and, to the best of our knowledge, has not been previously reported. Case presentation A 43-year-old Caucasian woman, gravida 4, para 0-2-1-0, presented for induction of labor secondary to diagnosis of XYY chromosomes found on a chorionic villus sample at 16+2 weeks by a first-trimester ultrasound. She denied contractions, leakage of fluid, or vaginal bleeding. Her past medical history was complicated by two previous abnormal pregnancies. Her first child had Zellweger syndrome, was delivered preterm at 36 weeks, and died at 4 years. The diagnosis of Zellweger was made first through biochemical testing of the child’s blood and then confirmed by molecular studies through a research protocol, which revealed two mutations. Correspondence: [email protected] Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Riley Hospital for Children at IU Health, 705 Riley Hospital Dr, Suite 2536, Indianapolis, IN 46202-5200, USA
Her second pregnancy ended with an induction of labor at 27 weeks due to Zellweger syndrome. She also has had a molar pregnancy. Her husband’s family history is only remarkable for his brother having an apparently isolated congenital heart defect. Gross examination of her placenta revealed a small placenta of 60g, 9.0 × 8.4 × 2.2cm placental disc with attached membranes and umbilical cord. The membranes were tan, semitranslucent with a marginal (50%) to circummarginate (50%) insertion. The point of rupture was indeterminate. The 13.5 × 0.5cm, two-vessel umbilical cord inserted eccentrically, 0.8cm from the disc margin. The fetal surface was purple–pink with small caliber vessels and minimal subchorionic fibrin deposition. The maternal surface was r
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