Gastroschisis, destructive brain lesions, and placental infarction in the second trimester suggest a vascular pathogenesis

Rebecca D. Folkerth, Donald M. Habbe, Theonia K. Boyd, Kristin Mcmillan, Jessica Gromer, Mary Ann Sens, Amy J. Elliott

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

The cause and pathogenesis of gastroschisis are uncertain. We report the autopsy and placental pathology of a stillbirth at 20 gestational weeks, in which gastroschisis was accompanied by destructive lesions in the cerebral cortex and brainstem, as well as cardiac calcification, consistent with ischemic injury during the 2nd trimester. An important potential underlying mechanism explaining the fetal abnormalities is the presence of infarcts in the placenta, indicative at this gestational age of maternal vascular underperfusion. The association of gastroschisis with ischemic lesions in the brain, heart, and placenta in this case supports the concept that gastroschisis, at least in some instances, may result from vascular event(s) causing disruption of the fetal abdominal wall and resulting in the extrusion of the abdominal organs, as well as hypoxic-ischemic brain and cardiac injury.

Original languageEnglish (US)
Pages (from-to)391-396
Number of pages6
JournalPediatric and Developmental Pathology
Volume16
Issue number5
DOIs
StatePublished - Sep 1 2013

Keywords

  • Atresia
  • Development
  • Encephaloclastic maternal vascular underperfusion
  • Vascular disruption

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine

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