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

García‐Díaz, Lutgardo; Carreto, Práxedes; Costa-Pereira, Susana; Antiñolo, Guillermo

doi:10.1186/1471-2393-12-72

Cited by 35 publications

(26 citation statements)

References 22 publications

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“…Location of the blood supply with Doppler and direct visualization of the target vessel endoscopically seem to result in the optimal definitive devascularization without additional long-term effects. It should be noted in these previous reports of successful laser photocoagulation, hydrops had yet to appear and the vessels were all small in caliber and superficial [5,11,12,19,20]. Any report of survival statistics should take into account the predefined indications for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…This is not a benign procedure, however. Amnioreduction in the setting of high cardiac output and possible fetal compromise led to abrupt fetal decompensation and hydrops [10,11,12]. One explanation for this rapid deterioration is that the decrease in intrauterine pressure from amnioreduction results in a sudden expansion of the tumor leading to increased shunting or decreased vascular resistance within the tumor [10].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Giant Chorioangiomas: Perinatal Outcomes and Techniques in Fetoscopic Devascularization

Lim¹,

Coleman²,

Polzin³

et al. 2014

Fetal Diagn Ther

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Objective: To evaluate the intrauterine management and perinatal outcome of pregnancies complicated by giant placental chorioangioma (>4 cm) and elaborate on various devascularization techniques. Materials and Methods: Retrospective review of 10 cases of giant placental chorioangioma evaluated between January 2005 and August 2012. Maternal demographics, prenatal imaging, response to fetoscopic treatment, obstetrical complications, and perinatal outcomes were evaluated. Results: Overall survival was 80%. Seven (70%) cases were associated with obstetrical complications, including polyhydramnios (n = 7), non-immune hydrops (n = 3), and high cardiac output state (n = 5). Five patients underwent fetoscopic devascularization at a mean gestational age of 24.03 weeks with 80% survival. The tumors were devascularized by bipolar coagulation (n = 1), combination of bipolar and diode laser (n = 2), bipolar and radiofrequency ablation (n = 1), and surgical clip application (n = 1). Postoperatively, all survivors had resolution of hydrops and high cardiac output states with survival beyond 60 days of life. Discussion: Fetoscopic devascularization is indicated for high cardiac output states or non-immune hydrops and may require multiple techniques including bipolar coagulation, clip application, and/or laser to interrupt arterial inflow and devascularize the mass.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Giant Chorioangiomas: Perinatal Outcomes and Techniques in Fetoscopic Devascularization

Lim¹,

Coleman²,

Polzin³

et al. 2014

Fetal Diagn Ther

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“…The major fetal risks associated with chorioangiomas are non-immune hydrops, cardiomegaly, congestive cardiac failure, prematurity and sudden infant death [12][13][14][15]. These complications are mainly explained by the existence of shunts and bleeding between maternal and fetal circulation, microangiopathic hemolysis, as well as placental insufficiency caused by the growth of the tumor [7,8].…”

Section: Discussionmentioning

confidence: 99%

A giant chorioangioma of the placenta with favorable outcome: a rare case presentation with literature review

Beyazıt¹,

Göret²,

Pek³

et al. 2016

Med-Science

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Chorioangioma, or hemangioma of the placenta, is the most frequent non-trophoblastic tumor of the placenta consisting of blood vessels and stroma. A great proportion of these tumors are small and well delineated within the placental parenchyma and have no or minimal adverse impact on the fetus. Unfortunately, large tumor size is linked to serious complications such as fetal anemia, hydrops and intrauterine death. This is probably because of arteriovenous shunts leading to progressive heart failure of the fetus. With the increasing rates of antenatal screenings with ultrasonography, prenatal diagnosis of these tumors is widely achieved. Here we report a case of giant placental chorioangioma diagnosed in the second trimester of pregnancy. The size of the tumor minimally increased during follow-up and at term, uncomplicated labor was achieved. Macroscopic and histologic examination confirmed the diagnosis.

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“…Typically, fetuses affected with Hb Bart disease end up with hydrops, fetal death, or stillbirth. In cases of no early pregnancy termination, most women carrying the affected baby develop severe preeclampsia, which has high mortality rate of up to 50% . To avoid morbidity and mortality, prenatal control is established.…”

Section: Introductionmentioning

confidence: 99%

The performance of cardio‐biparietal ratio measured by 2D ultrasound in predicting fetal hemoglobin Bart disease during midpregnancy: A pilot study

2019

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Objective: The aim of this study was to assess the performance of cardio-biparietal ratio measured by real-time two-dimensional ultrasound in predicting hemoglobin (Hb) Bart disease among fetuses at risk.Method: This prospective diagnostic study recruited pregnancies at risk for Hb Bart disease at 17 to 22 weeks' gestation. Cardio-biparietal ratio and cardiothoracic ratio were measured before cordocentesis for Hb typing. The performance of the cardiobiparietal ratio and cardiothoracic ratio for identifying affected fetuses was evaluated.Results: Among 72 fetuses at risk, 31 were diagnosed as affected by Hb Bart disease. By using a cutoff 0.45, cardio-biparietal ratio had a sensitivity of 83.9%, specificity of 92.7%, positive predictive value of 89.7%, and negative predictive value of 88.4%, whereas cardiothoracic ratio using cutoff 0.5 had a sensitivity of 94.3%, specificity of 65.1%, positive predictive value of 68.8%, and negative predictive value of 93.3%.Conclusion: Cardio-biparietal ratio is a new sonomarker to predict Hb Bart disease among fetuses at risk. This sonomarker is relatively effective and may be useful in areas of high prevalence of alpha thalassemia disease, limited number of experts in prenatal ultrasound, and difficult access to prenatal diagnosis.

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

Cited by 35 publications

References 22 publications

Giant Chorioangiomas: Perinatal Outcomes and Techniques in Fetoscopic Devascularization

Giant Chorioangiomas: Perinatal Outcomes and Techniques in Fetoscopic Devascularization

A giant chorioangioma of the placenta with favorable outcome: a rare case presentation with literature review

The performance of cardio‐biparietal ratio measured by 2D ultrasound in predicting fetal hemoglobin Bart disease during midpregnancy: A pilot study

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