Radio frequency ablation for the intrauterine treatment of giant placental chorioangioma associated with fetal compromise: A case report

Zhao, Bingyi; Li, Yin; Chu, Wei; Wang, Fangna; Huo, Ping; Jian, Gao

doi:10.1002/bdr2.2106

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…A promising therapeutic approach for managing symptomatic cases involves blocking the tumor-feeding vessels. Various methods for achieving this objective include fetoscopy-assisted laser ablation or suture ligation, alcohol injection, microcoil embolization, and ultrasound-guided embolization 3,24,25 . The selection of the most appropriate vessel occlusion technique depends on factors such as the anatomical location or diameter of the target vessel and its proximity to the umbilical cord insertion site 2 .…”

Section: Discussionmentioning

confidence: 99%

Multiple Giant Placental Chorioangioma: A Case Report

Hashemi,

Alamdarloo,

Vafaei

et al. 2024

Preprint

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Section: Discussionmentioning

confidence: 99%

Multiple Giant Placental Chorioangioma: A Case Report

Hashemi,

Alamdarloo,

Vafaei

et al. 2024

Preprint

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Multiple giant placental chorioangioma: A case report

Hashemi,

Moradi Alamdarloo,

Vafaei

et al. 2024

Clinical Case Reports

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Key Clinical MessageGiant chorioangiomas, despite being rare, pose significant fetal and maternal risks. Timely and individualized treatment plans are crucial to reduce morbidity and mortality when fetal compromise occurs. Additionally, successful conservative management relies on consistent ultrasound monitoring, Doppler flowmetry assessments, and amniotic fluid level measurements.AbstractChorioangiomas are benign placental tumors that manifest in approximately 1% of pregnancies. Giant chorioangiomas, characterized by tumors exceeding 4 cm, are exceptionally rare and pose substantial risks to maternal and fetal health. This case report details a patient with multiple giant chorioangiomas, emphasizing the rarity and consequential complications associated with these tumors. A 23‐year‐old woman, G3P2, at 28 weeks gestational age, was diagnosed with multiple large, well‐defined placental masses with increased vascularity, indicative of giant placental chorioangiomas. Subsequent ultrasound revealed various fetal anomalies such as cleft palate and lip, as well as lung and heart abnormalities. At 34+5 weeks of gestation, an emergency cesarean section was performed due to preeclampsia. Subsequently, a female neonate was born with hydrops fetalis. Unfortunately, she passed away within the first hour of her life. Complications associated with chorioangiomas primarily arise from arteriovenous shunts, which potentially lead to compromised fetal perfusion and cardiac failure. Although small‐sized chorioangiomas are often discovered incidentally, Doppler ultrasound and magnetic resonance imaging can reliably distinguish these tumors from other placental lesions. Additionally, management strategies tailored to gestational age and maternal‐fetal symptoms typically necessitate a multidisciplinary approach. However, additional research is essential to understand the mechanisms of chorioangiomas and to develop comprehensive management guidelines.

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Radiofrequency thermal ablation of giant placental chorioangioma complicated with fetal hydrops: a case report and successful outcome

Hamer,

Gurney,

Meher

et al. 2024

Case Reports in Perinatal Medicine

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Objectives Chorioangiomas are the most frequently occurring type of benign tumour of the placenta. However, large chorioangiomas greater than 4 cm are rare and can be more frequently associated with serious complications such as: polyhydramnios, hydrops fetalis, fetal anaemia, intrauterine growth restriction, preterm birth, and an increased risk of perinatal mortality. Importantly timely prenatal diagnosis with close surveillance alongside potential intrauterine intervention can prove impactful on pregnancy outcome and fetal survival. Case presentation We present a case of a 36-year-old female referred to our tertiary fetal medicine unit at 28 weeks’ gestation with a large chorioangioma measuring 9.4×8.8×5.5 cm and ultrasonographic evidence of severe fetal anaemia and fetal hydrops. The patient underwent an intrauterine transfusion and in utero surgical therapy with radiofrequency ablation (RFA). Immediately following the procedure, the fetus sustained a period of bradycardia, followed by asystole. Delivery was expedited via emergency caesarean section. Careful planning and rapid delivery after fetal intervention within the most appropriate surgical setting mitigated risks for the baby and resulted in a positive outcome. The baby was discharged from the neonatal unit on day 84 of life. Conclusions Large placental chorioangiomas are a rare occurrence, however, when associated with fetal complications present a high incidence of adverse perinatal outcomes. In utero interventions require careful planning and surgical expertise to ensure improved fetal and neonatal outcomes. To the best of our knowledge this case is the first recorded instance of a successful postnatal outcome following RFA for a large placental chorioangioma, whereby the fetus was complicated by fetal hydrops.

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Radio frequency ablation for the intrauterine treatment of giant placental chorioangioma associated with fetal compromise: A case report

Cited by 3 publications

References 23 publications

Multiple Giant Placental Chorioangioma: A Case Report

Multiple Giant Placental Chorioangioma: A Case Report

Multiple giant placental chorioangioma: A case report

Radiofrequency thermal ablation of giant placental chorioangioma complicated with fetal hydrops: a case report and successful outcome

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