Pravastatin to prevent recurrent fetal death in massive perivillous fibrin deposition of the placenta (MPFD)

Tinnakorn Chaiworapongsa, Roberto Romero, Steven J. Korzeniewski, Piya Chaemsaithong, Edgar Hernandez-Andrade, James H. Segars, Alan H. Decherney, M. Cathleen McCoy, Chong Jai Kim, Lami Yeo, Sonia S. Hassan

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Massive perivillous fibrin deposition of the placenta (MPFD) or maternal floor infarction (MFI) is a serious condition associated with recurrent complications including fetal death and severe fetal growth restriction. There is no method to evaluate the risk of adverse outcome in subsequent pregnancies, or effective prevention. Recent observations suggest that MFI is characterized by an imbalance in angiogenic/anti-angiogenic factors in early pregnancy; therefore, determination of these biomarkers may identify the patient at risk for recurrence. We report the case of a pregnant woman with a history of four consecutive pregnancy losses, the last of which was affected by MFI. Abnormalities of the anti-angiogenic factor, sVEGFR-1, and soluble endoglin (sEng) were detected early in the index pregnancy, and treatment with pravastatin corrected the abnormalities. Treatment resulted in a live birth infant at 34 weeks of gestation who had normal biometric parameters and developmental milestones at the age of 2. This is the first reported successful use of pravastatin to reverse an angiogenic/anti-angiogenic imbalance and prevent fetal death. This work was authored as part of the Contributor's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copiright protection is available for such works under U.S. Law.

Original languageEnglish (US)
Pages (from-to)855-862
Number of pages8
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number6
StatePublished - Mar 18 2016
Externally publishedYes


  • Angiogenic factors
  • Maternal floor infarction
  • Placental growth factor
  • Preeclampsia
  • Proton pump inhibitor
  • Soluble endoglin
  • Soluble vascular endothelial growth factor receptor-1

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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