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March 2019 — Anatomic Pathology

A 37-year-old G4P1212 patient presented to labor and delivery for preterm premature rupture of membranes (PPROM) at 25 3/7 weeks gestation. Prior to presentation, the patient’s pregnancy was uncomplicated. Immediately following rupture of membranes, the patient noticed a non-malodourous milky discharge. A bacterial urine culture was negative. The patient was afebrile, but due to fetal and maternal tachycardia, there was clinical concern for acute chorioamnionitis. Prenatal steroids and latency antibiotics (gentamicin and clindamycin) were administered, and a classical cesarean section was performed.

Macroscopic and microscopic evaluation of the placenta demonstrated the following findings:

Figure 1 –Placenta, Fetal Surface
Figure 2 – Umbilical cord with numerous white-yellow plaques
Figure 3 – Umbilical cord, H&E
Figure 4 – Umbilical cord, GMS stain

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E. Heidi Cheek, M.H.S., PA(ASCP)CM
Pathologists' Assistant
Mayo Clinic
Assistant Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine
J. Kenneth Schoolmeester, M.D.
Consultant, Anatomic Pathology
Mayo Clinic
Assistant Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine
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