Watchful Expectant Management of a Giant Placental Chorioangioma With Favorable Maternal and Fetal Outcomes: A Case Report

Abstract

Placental chorioangioma is the most common benign tumor of the placenta. However, clinically evident chorioangiomas are less common with an incidence ranging between 1:3,500 and 1:9,000 births. In the majority of cases, it is small or microscopic and of no clinical significance. If it increases more than 5 cm in size, then it may be associated with serious maternal complications such as mirror syndrome, polyhydramnios, preeclampsia, antepartum hemorrhage, preterm labor and delivery, and postpartum hemorrhage, as well as fetal complications such as fetal anemia, fetal thrombocytopenia, fetal hydrops, intrauterine growth restriction, fetal demise, and neonatal death. Giant chorioangioma associated with polyhydramnios leads to high perinatal morbidity and mortality. Chorioangioma with complications before fetal viability needs interventions. Conservative management with close surveillance can be considered in selective cases. We report a case of giant placental chorioangioma complicated with severe polyhydramnios managed conservatively with favorable maternal and fetal outcomes.

Multiple Giant Placental Chorioangioma: A Case Report

“…These shunts compromise the perfusion of chorionic villi, leading to reduced delivery of essential nutrients and oxygen to the fetal circulation. As a result, the fetal heart compensates to maintain tissue perfusion 1,7,11 . However, inadequate compensation may result in cardiac failure and hydrops fetalis, which often leads to adverse outcomes and fetal mortality 3 , as observed in our case.…”

“…Chorioangioma is a benign vascular tumor of the placenta that occurs in approximately 1% of pregnancies 1 . The majority of cases are small and asymptomatic, with symptoms appearing in only 0.01%-0.03% of instances 2 .…”

Corioangioma e seguimento clínico em uma maternidade terciária do estado do Ceará – relato de caso

“…As complicações de início precoce necessitam de encaminhamento para uma unidade de medicina fetal; no entanto, as complicações de início tardio podem ser tratadas com monitoramento rigoroso e parto oportuno. (9) Limitações do estudo: Não dispomos no hospital relatado os equipamentos necessários para realização de intervenção intra útero, como coagulação a laser do suprimento sanguíneo do corioangioma placentário. Portanto, não foi possível comparar os desfechos com manejo conservador x manejo intervencionista.…”

“…Mais estudos/pesquisas são necessários para formular critérios objetivos de seleção para manejo conservador e intervencionista. (9)…”