P263: Perinatal outcome after prenatal diagnosis of placental chorioangioma

Abstract

To review the prenatal complications, management, and perinatal outcome in pregnancies complicated by placental chorioangioma (PCA). Cases of PCA diagnosed prenatally as part of a prospective, multicentric program for fetal diagnosis and therapy were identified. All cases were evaluated with color flow imaging. In the latter part of the study, three-dimensional sonography, including power-Doppler angiography, was also used to study the vascular pattern of the tumor. Information on maternal demographics, prenatal sonographic findings, pregnancy complications, antenatal intervention, and perinatal outcome was obtained by reviewing the medical records or contacting the referring obstetricians. In the 5-year period from January 1997 and December 2001, 11 cases of PCA were diagnosed prenatally. Nine cases were diagnosed in singleton pregnancies and two in twin gestations. Among the nine cases occurring in singletons, five were associated with pregnancy complications, including polyhydramnios (n = 3), oligohydramnios (n = 2), fetal growth restriction (n = 2), and hydrops fetalis due to cardiac failure (n = 1). Overall, two fetuses died, including one of the monochorionic twins due to complications of twin-twin transfusion syndrome. Four of the nine singleton pregnancies delivered before 35 weeks. In four pregnancies, no prenatal complications were detected in spite of continuous growth and vascularity of the placental mass in three of those cases. PCA is associated with an increased risk of pregnancy complications, the most common being polyhydramnios and preterm delivery. In selected cases, amniodrainage allows continuation of the pregnancy with improved perinatal outcome. Fetuses who develop hydrops are at the highest risk for perinatal death, with limited therapeutic options in these cases being available. Close follow-up is advised, even in those cases with no associated findings at the time of the diagnosis.