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BMC Pregnancy and Childbirth

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Open Access 01-12-2012 | Case report

Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror syndrome

Authors: Lutgardo García-Díaz, Práxedes Carreto, Susana Costa-Pereira, Guillermo Antiñolo

Published in: BMC Pregnancy and Childbirth | Issue 1/2012

Abstract

Background

Giant placental chorioangiomas have been associated with a number of severe fetal complications and high perinatal mortality.

Case presentation

We report a case of giant chorioangioma with fetal hydrops, additionally complicated by severe anemia, mild cardiomegaly with hyperdinamic heart circulation and maternal mirror syndrome. Intrauterine blood transfusion and amniodrainage was performed at 29 weeks. Worsening of the fetal and maternal condition prompted us to proceed with delivery at 29 + 5 weeks. The newborn died 3 hours later due to pulmonary hypoplasia and hemodynamic failure. Maternal course was favourable, mirror syndrome resolved in the second day and the patient was discharged four days following delivery.

Conclusions

In the case described here, fetal condition got worse despite of the anemia correction and amniodrainage. Our outcome raises the issue whether additional intrauterine clinical intervention, as intersticial laser, should have been performed to stop further deterioration of the fetal condition when progressive severe hydrops develops.

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Fox H, Sebire NJ: Non-trophoblastic tumors of the placenta. Pathology of the Placenta. Edited by: Fox H, Sebire N. 2007, Philadelphia: Saunders Elsevier, 401-430. 3CrossRef

Sepulveda W, Aviles G, Carstens E, Corral E, Perz N: Prenatal diagnosis of solid placental masses; the value of color flow imaging. Ultrasound Obstet Gynecol. 2000, 16: 554-558. 10.1046/j.1469-0705.2000.00245.x.CrossRefPubMed

Sepulveda W, Alcalde JL, Schnapp C, Bravo M: Perinatal outcome after prenatal diagnosis of placental chorioangioma. Obstet Gynecol. 2003, 102: 1028-1033. 10.1016/S0029-7844(03)00859-7.PubMed

Bhide A, Prefumo F, Sairam S, Carvalho JS, Thilaganathan BT: Ultrasound-guided interstitial laser therapy for the treatment of placental chorioangioma. Obstet Gynecol. 2003, 102: 1189-1191. 10.1016/S0029-7844(03)00706-3.PubMed

Nicolini U, Zuliani G, Caravelli E, Fogliani R, Poblete A, Roberts A: Alcohol injection: a new method of treating placental chorioangiomas. Lancet. 1999, 353: 1674-1675.CrossRefPubMed

Jauniaux E, Kadri R, Donner C, Rodesch F: Not all chorioangiomas are associated with elevated maternal serum alphafetoprotein. Prenat Diagn. 1991, 11: 73-74.

Zanardini C, Papageorghiou A, Bhide A, Thilaganathan B: Giant placental chorioangioma: natural history and pregnancy outcome. Ultrasound Obstet Gynecol. 2010, 35: 332-336. 10.1002/uog.7451.CrossRefPubMed

Quintero RA, Reich H, Romero R, Johnson MP, Goncalves L, Evans MI: In utero endoscopic devascularization of a large chorioangioma. Ultrasound Obstet Gynecol. 1996, 8: 48-52. 10.1046/j.1469-0705.1996.08010048.x.CrossRefPubMed

Wehrens X, Offermans JPM, Snijders M, Peeters L: Fetal cardiovascular response to large placental Chorioangiomas J. Perinat Med. 2004, 32: 107-112.CrossRef

10.

Sivaslı E, Tekşam Ö, Haliloğlu M, Güçer S, Orhan D, Gürgey A, Tekinalp G: Hydrops fetalis associated with chorioangioma and thrombosis of umbilical vein. Turk J Pediatr. 2009, 51: 515-518.PubMed

11.

Haak MC, Oosterhof H, Mouw RJ, Oepkes D, Vandenbussche FPHA: Pathophysiology and treatment of fetal anemia due to placental chorioangioma. Ultrasound Obstet Gynecol. 1999, 14: 68-70. 10.1046/j.1469-0705.1999.14010068.x.CrossRefPubMed

12.

Escribano D, Galindo A, Arbués J, Puente JM, De la Fuente P: Prenatal management of placental chorioangioma: value of the middle cerebral artery peak systolic velocity. Fetal Diagn Ther. 2006, 21: 489-493. 10.1159/000095659.CrossRefPubMed

13.

Lau TK, Yu SCH, Leung TY, To KF, Fung TY, Leung TN: Prenatal embolisation of a large chorioangioma using enbucrilate. BJOG. 2005, 112: 1002-1004. 10.1111/j.1471-0528.2005.00567.x.CrossRefPubMed

14.

Wanapirak C, Tongsong T, Sirichotiyakul S, Chanprapapah P: Alcoholization: the choice of intrauterine treatment for chorioangioma. J Obstet Gynaecol Res. 2002, 28: 71-75. 10.1046/j.1341-8076.2002.00016.x.CrossRefPubMed

15.

Deren O, Ozyuncu O, Onderoglu LS, Durukan T: Alcohol injection for the intrauterine treatment of chorioangioma in a pregnancy with transfusion resistant fetal anemia: a se report. Fetal Diagn Ther. 2007, 22: 203-205. 10.1159/000098718.CrossRefPubMed

16.

Bermudez C, Luengas O, Perez-Wulff J, Genatios U, Garcia V, Guevara-Zuloaga F, Quintero RA: Management of a placental chorioangioma with endoscopic devascularization and intrauterine transfusions. Ultrasound Obstet Gynecol. 2007, 29: 97-98. 10.1002/uog.3903.CrossRefPubMed

17.

Quarello E, Bernard JP, Leroy B, Ville Y: Prenatal laser treatment of a placental chorioangioma. Ultrasound Obstet Gynecol. 2005, 25: 299-301. 10.1002/uog.1848.CrossRefPubMed

18.

Mendez-Figueroa H, Papanna R, Popek EJ, Byrd RH, Goldaber K, Moise KJ, Jonson A: Endoscopic laser coagulation following amnioreduction for the management of a large placental chorioangioma. Prenat Diagn. 2009, 29: 1277-1278. 10.1002/pd.2400.CrossRefPubMed

19.

Braun T, Brauer M, Fuchs I, Czernik C, Dudenhausen J, Henrich W, Sarioglu N: Mirror Syndrome: A Systematic Review of Fetal Associated Conditions, Maternal Presentation and Perinatal Outcome. Fetal Diagn Ther. 2010, 27: 191-203. 10.1159/000305096.CrossRefPubMed

20.

Dorman SL, Cardwell MS: Ballantyne syndrome caused by a large placental chorioangioma. Am J Obstet Gynecol. 1995, 173: 1632-1633. 10.1016/0002-9378(95)90666-5.CrossRefPubMed

21.

Gherman RB, Incerpi MH, Wing DA, Goodwin TM: Ballantyne syndrome: is placental ischemia the etiology?. J Matern Fetal Med. 1998, 7: 227-229.PubMed

22.

Galimberti A, Jain S: Placental chorioangioma as a cause of maternal hydrops syndrome. J Obstet Gynaecol. 2000, 20: 91-10.1080/01443610063633.CrossRefPubMed

23.

Zoppini C, Acaia B, Lucci G, Pugni L, Tassis B, Nicolini U: Varying Clinical Course of large Placental Chorioangiomas. Report of 3 cases. Fetal Diagn Ther. 1997, 12: 61-64. 10.1159/000264430.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2393/12/72/prepub

Title: Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror syndrome
Authors: Lutgardo García-Díaz
Práxedes Carreto
Susana Costa-Pereira
Guillermo Antiñolo
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2012
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/1471-2393-12-72

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror syndrome

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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