Giant placental chorioangioma: Natural history and pregnancy outcome

Abstract

Objectives Giant placental chorioangiomas are associated with a high prevalence of pregnancy complications and a poor perinatal outcome. The aim of the study was to evaluate the natural history, intrauterine treatment and outcome of pregnancies complicated by giant placental chorioangioma. Methods This was a retrospective study of 19 cases of giant placental chorioangioma, in which the natural history, intrauterine treatment and outcome ofpregnancy were evaluated. Results Eighteen of the 19 cases were associated with a wide variety of fetal complications, including polyhy-dramnios, growth restriction, hyperdynamic circulation, cardiomegaly, anemia and non-immune hydrops. Two- thirds ofthe cases developed complications that required either elective delivery for fetal growth restriction (n = 6) or intervention for cardiovascular effects (n = 7). Fetal therapy, when required, was tailored to the particular complication and resulted in a successful pregnancy in all cases. Conclusions The presence of large placental chorioan- gioma is associated with the development offetal growth restriction and hyperdynamic state in a significant number ofcases. This series elucidates some ofthe putative underlying mechanisms for these complications, and reports on a safe and effective treatment modality, percutaneous ultrasound-guided interstitial laser therapy. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.