Antenatal Diagnosis of a Giant Fetal Hepatic Hemangioma and Treatment with Maternal Corticosteroid

Abstract

Initial diagnosis of a fetal hemangioendothelioma of the liver was made at 28 + 1 weeks of gestation. Due to the growth of the liver tumor and increasing fetal cardiac load, 4 mg dexamethasone were administered daily from 32 + 3 to 36 + 6 weeks of gestation. With this medication the fetal cardiac load was unchanged and slow further increase of the tumor size occurred. At 36 + 6 weeks of gestation, a primary caesarean section was performed due to fetal heart decompensation and pathological CTG. Maternal therapy with dexamethasone should be considered for antenatally detected Giant Fetal Hepatic Hemangioma.

Zusammenfassung

Es wurde in der 28 + 1 Schwangerschaftswoche die Erstdiagnose eines fetalen Hämangioendotheliom der Leber gestellt. Aufgrund des Größenwachstums des Lebertumors und einer zunehmenden fetalen kardialen Belastung erfolgte von der 32 + 3 bis zur 36 + 6 Schwangerschaftswoche eine Therapie mit täglich 4 mg Dexamethason oral. Unter dieser Medikation reduzierte sich die fetale kardiale Belastung und es kam zu keiner weiteren Größenzunahme des Tumors. In der 36 + 6 Schwangerschaftswoche wurde eine primäre Sectio wegen wieder zunehmender fetaler Dekompensation und suspektem CTG durchgeführt. Bei pränataler Diagnose eines Hämangioendothelioms der Leber scheint ein Therapieversuch mit Dexamethason sinnvoll.

Key words

fetus - hemangioma - obstetrics - pregnancy - 3 D ultrasound

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