Abstract
IntroductionA chorioangioma is the most common benign tumor of the placenta. The majority of pregnancies with chorioangiomas are asymptomatic. Pregnancies with large chorioangiomas are associated with maternal and fetal complications, such as growth restriction, cardiomegaly, congestive heart failure, fetal anemia, thrombocytopenia, nonimmune hydrops and intrauterine fetal death. There are several modalities of treatment published to date with various results. Our case was the third such case report published on the successful treatment with antenatal embolization of the feeding vessel of the chorioangioma. To the best of our knowledge, there have been no published cases about antenatal treatment of placental chorioangiomas in Saudi Arabia, or any other Gulf state.Case presentationWe describe the case of a 28-year-old Arab woman diagnosed at 22 weeks of gestation with a chorioangioma. A glue material - enbucrilate (Histoacryl) - was used for embolization of the feeding vessel. Intrauterine fetal blood transfusions were performed twice, as a treatment for fetal anemia. The fetus developed heart failure at 30 weeks of gestation. A Cesarean section was performed and the outcome was a live baby with right ventricular hypertrophy. The baby was admitted to our neonatal intensive care unit and discharged at 42 days following birth in a stable condition,with follow-up with our cardiology team.ConclusionIn this case, we found that intrauterine embolization of the feeding vessel of a chorioangioma with Histoacryl was a valid treatment option that carried a small risk considering the good pregnancy outcome.
Highlights
A chorioangioma is the most common benign tumor of the placenta
Case presentation: We describe the case of a 28-year-old Arab woman diagnosed at 22 weeks of gestation with a chorioangioma
The baby was admitted to our neonatal intensive care unit and discharged at 42 days following birth in a stable condition,with follow-up with our cardiology team. In this case, we found that intrauterine embolization of the feeding vessel of a chorioangioma with Histoacryl was a valid treatment option that carried a small risk considering the good pregnancy outcome
Summary
Chorioangiomas are the most common placental tumors. Generally, if the tumor size is less than 4 cm it does not cause any symptoms during pregnancy, and will often pass undetermined until examination of the placenta following delivery. Case presentation Our patient was a 28-year-old Arab woman, gravida 3 para 2 with a history of nonconsanguinity, with two previous full-term normal spontaneous vaginal deliveries and an unremarkable past medical, surgical and family history She was referred to our hospital at 22 weeks of gestation with severe hydramnios and a placental tumor, for investigations and management. An ultrasound examination revealed normal fetal growth for gestational age Her amniotic fluid index was 48 cm, with the deepest pocket of 13 cm and no signs of fetal hydrops. The pregnancy was followed up weekly with ultrasound, which showed normal fetal growth, stable amniotic fluid index with no signs of hydrops, and no flow through the placental tumor (Figure 4). At 29 weeks’ gestation, ultrasound Doppler of the MCA PSV was 76.3 cm/s This was 1.97 MoM for Figure 4 Chorioangioma post embolization. The baby was eventually discharged from the NICU at 42 days old with a follow-up appointment with our cardiology team
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