Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror syndrome
1 Unidad de Gestión Clínica de Genética, Reproducción y Medicina Fetal. Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
2 Servicio de Obstetricia y Ginecologia, Hospital Juan Ramón Jiménez, Huelva, Spain
3 Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Sevilla, Spain
4 Director de la Unidad de Gestión Clínica de Genética, Reproducción y Medicina Fetal, Hospital de la Mujer, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013, Sevilla, Spain
BMC Pregnancy and Childbirth 2012, 12:72 doi:10.1186/1471-2393-12-72Published: 28 July 2012
Giant placental chorioangiomas have been associated with a number of severe fetal complications and high perinatal mortality.
We report a case of giant chorioangioma with fetal hydrops, additionally complicated by severe anemia, mild cardiomegaly with hyperdinamic heart circulation and maternal mirror syndrome. Intrauterine blood transfusion and amniodrainage was performed at 29 weeks. Worsening of the fetal and maternal condition prompted us to proceed with delivery at 29 + 5 weeks. The newborn died 3 hours later due to pulmonary hypoplasia and hemodynamic failure. Maternal course was favourable, mirror syndrome resolved in the second day and the patient was discharged four days following delivery.
In the case described here, fetal condition got worse despite of the anemia correction and amniodrainage. Our outcome raises the issue whether additional intrauterine clinical intervention, as intersticial laser, should have been performed to stop further deterioration of the fetal condition when progressive severe hydrops develops.