P30.12: Prenatal diagnosis of velamentous cord insertion and vasa previa by MRI: a case report

Abstract

Congenital hemangiomas are rare solitary lesions, mostly located in the head and the limbs. Giant hemangiomas are frequently associated with life-threatening complications such as high-output heart failure, anemia, thrombocytopenia and disseminated intravascular coagulopathy (Kasabach-Merritt syndrome). Prenatal diagnosis and management is possible in the second and third trimesters of pregnancy with twoand three-dimensional sonography, color Doppler ultrasound and magnetic resonnace imaging. We present two cases of cutaneous limb hemangioma. In the first fetus, anemia and heart failure were the presenting features associated to the diagnosis of a giant hemangioma of the leg at 26 weeks of pregnancy. After full information on diagnosis and prognosis, future parents decided to terminate the pregnancy. In the second fetus, an upper limb hemangioma was diagnosed at 33 weeks of pregnancy. Delivery was anticipated because anemia was suspected. After birth, a low platelet count was descovered, pointing to a Kasabach-Merritt sequence. The female newborn was started on high dose prednisone with a rapid reduction in size of the tumor. These examples illustrate the variable outcome of seemingly similar hemangiomas and underlines the value of proper imaging studies in making accurate decisions with respect to handling.