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
