Thrombosis of the Renal Vein and Inferior Vena Cava Associated With Placental Fetal Vascular Malperfusion in a Neonate Exposed to Methadone Maintenance Therapy In Utero

• Published in: Pediatric and developmental pathology Vol. 24; no. 1; p. 56
• Main Authors: Guerrero, J C, Kim, Joseph, Santi, Mariarita, Ruchelli, Eduardo, Carreon, Chrystalle Katte
• Format: Journal Article
• Language: English
• Published: United States 01.01.2021
• Subjects: opioid use disorder; methadone maintenance therapy; delayed villous maturation; fetal vascular malperfusion; renal vein thrombosis; neonatal demise
• ISSN: 1615-5742
• DOI: 10.1177/1093526620962062

Methadone, an opioid agonist, is the recommended treatment for pregnant women with opioid use disorder (OUD). Fetal/neonatal autopsy findings as well as placental changes in the setting of maternal OUD or methadone maintenance therapy (MMT) are not well-characterized. Here we present a case of a neonate who had exposure to MMT while in utero and died shortly after birth and was subsequently found to have multifocal calcified renal vein thrombosis, a recent inferior vena cava thrombus, and placental features of fetal vascular malperfusion at autopsy.