Role of Antenatal Intervention and Pregnancy Outcome in Large Chorioangiomas

Abstract

Chorioangioma is a non-trophoblastic benign vascular tumour of the placenta affecting fetal outcome. It has no malignant potential. It is usually diagnosed during the 2nd trimester. These are usually found on the fetal side of the placenta, close to the umbilical cord insertion site protruding into the amniotic cavity. Chorioangiomas can be small or large. Small tumours (less than 5 cm) usually have favourable outcome. Large chorioangiomas (more than 5 cm) usually have an unfavourable outcome and may cause maternal complications like pre-eclampsia, preterm labour, placental abruption, placenta previa, polyhydramnios and post partum haemorrhage and fetal complications like anemia, thrombocytopenia, growth restriction, hydrops, cardiomegaly, congestive heart failure and intrauterine fetal demise. With the use of ultrasound and color Doppler, it has become possible to diagnose these early and provide timely intervention in order to prevent fatal complications. Here, we present a case of a large chorioangioma, 10 ⅹ 8.7 ⅹ 9.3 cm, with significant high vascularity and fetal anemia. There was a significant reduction in the size of tumour after interstitial laser coagulation. Following this, an intrauterine transfusion helped in correcting anemia. Other intervention options available for chorioangiomas are endoscopic surgical devascularization, alcoholic ablation and radiofrequency ablation. Polyhydramnios if present, is treated with therapeutic amniocentesis. Delivery is to be considered in case of complications after 34 weeks of gestation. Small chorioangiomas are usually favourable and require close fetal monitoring only.

Keywords

Chorioangioma - Non trophoblastic - Benign - Anemia - Intervention

Publikationsverlauf

Eingereicht: 03. Januar 2020

Angenommen: 27. Februar 2020

Artikel online veröffentlicht:
05. Mai 2023