Alcoholization: the choice of intrauterine treatment for chorioangioma.
Chorioangioma is a vascular tumor of the placenta. Most are small and asymptomatic, whereas the large tumors are clinically significant and often associated with polyhydramnios and fetal heart failure. To prevent fetal loss from these complications, many interventions have been proposed, including intrauterine transfusion in anemic cases and fetoscopic surgery to ablate the feeding vessels. The case presented herein had large chorioangiomas, 8 and 4cm in diameter, associated with polyhydramnios and early signs of hydrops fetalis, diagnosed at 27 weeks gestation. After extensive counseling, we performed alcohol ablation of the feeding vessel of the larger tumor. Signs of fetal heart failure and hydrops fetalis disappeared dramatically. The pregnancy was extended for 2 weeks, followed by premature rupture of the membranes and spontaneous labor at 32 weeks gestation and a surviving female baby, weighing 1360g, was delivered uneventfully. This preliminary experience suggests that alcoholization may be one of the best choices for this condition due to its high efficacy, simplicity, safety and very low cost. To our knowledge, this is the first report using alcoholization for the treatment of hydrops fetalis secondary to chorioangioma.
Wanapirak
Chanane
C
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand. cwanapir@mail.med.cmu.ac.th
Tongsong
Theera
T
Sirichotiyakul
Supatra
S
Chanprapaph
Pharuhas
P
D000328:Adult; D000431:Ethanol / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006391:Hemangioma / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology / Q000628:therapy; D007269:Injections, Intra-Arterial; D010920:Placenta / Q000098:blood supply; D010922:Placenta Diseases / Q000150:complications / Q000188:drug therapy*; D006831:Polyhydramnios / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal
D000431:Ethanol