What is massive perivillous fibrin deposition?

Massive perivillous fibrin deposition (MPFD) is a rare pregnancy complication that usually occurs in the second or third trimester. It is characterized by the excessive accumulation of fibrin in the perivillous space (the space between the placental villi and the maternal blood space) and can lead to severe fetal growth restriction, fetal distress, stillbirth, and maternal complications such as pre-eclampsia and postpartum hemorrhage.

The exact cause of MPFD is unknown, but it is thought to be associated with abnormalities in the blood vessels of the placenta and an inflammatory response. MPFD is often detected during routine ultrasound scans when the fetus is found to have a smaller than expected size or weight for their gestational age. However, the diagnosis can only be confirmed after delivery when an examination of the placenta is carried out.

There is no specific treatment for MPFD, and the management of the condition is primarily focused on optimizing fetal health through frequent monitoring and delivering the baby as soon as safely possible. In severe cases, delivery may need to be carried out prematurely, even if the fetus is not yet fully developed.

MPFD is a challenging condition to manage, and it requires a multidisciplinary approach involving obstetricians, neonatologists, and other healthcare professionals. The prognosis of MPFD depends on the severity of the condition and the gestational age of the baby at delivery. With appropriate management, most pregnancies can be successful, and the baby can be delivered healthy.