Giant placental chorioangioma: natural history and pregnancy outcome.
OBJECTIVE
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 of pregnancy were evaluated.


RESULTS
Eighteen of the 19 cases were associated with a wide variety of fetal complications, including polyhydramnios, growth restriction, hyperdynamic circulation, cardiomegaly, anemia and non-immune hydrops. Two-thirds of the 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 chorioangioma is associated with the development of fetal growth restriction and hyperdynamic state in a significant number of cases. This series elucidates some of the putative underlying mechanisms for these complications, and reports on a safe and effective treatment modality, percutaneous ultrasound-guided interstitial laser therapy.
Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, UK.
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Zanardini
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Papageorghiou
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Bhide
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Thilaganathan
D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000209:etiology; D006391:Hemangioma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation; D010922:Placenta Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D006831:Polyhydramnios / Q000000981:diagnostic imaging / Q000209:etiology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging* / Q000601:surgery; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal