title: Fetal and placental vascular tumors: persistent fetal hyperdynamic status predisposes to poorer long-term neurodevelopmental outcome.
abstract: OBJECTIVE
  To evaluate the association between fetal hemodynamic changes seen in the presence of vascular tumors of fetal or placental origin and risk of adverse pregnancy outcome.
  
  
  METHODS
  All cases of placental chorioangioma, sacrococcygeal teratoma and pulmonary sequestration during a 10-year period were included. Ultrasound data and pregnancy and long-term neurodevelopmental outcomes were assessed in this cohort. A survival analysis was performed to assess the relationship between the cardiovascular profile score (CVPS) and adverse pregnancy outcome.
  
  
  RESULTS
  There were 56 fetal or placental tumors, including 28 chorioangiomas, 10 sacrococcygeal teratomas and 18 pulmonary sequestrations, diagnosed at a median gestation of 23 + 3 weeks. Abnormal CVPS (≤ 8) was seen in 30% of sacrococcygeal teratomas and in 46% of chorioangiomas, but in none of the pulmonary sequestration cases. Adverse pregnancy outcome occurred in 11 cases (three stillbirths, three neonatal deaths and five cases of developmental delay) and only in those cases in which the tumors were associated with a CVPS of ≤ 8.
  
  
  CONCLUSIONS
  Certain fetal and placental vascular tumors are associated with cardiac dysfunction in fetal life. When the CVPS is low (≤ 8), these cases are at increased risk of both fetal/neonatal demise as well as overt long-term neurodevelopmental disability. The long-term neurodevelopmental outcome should be formally and prospectively assessed in cases of fetal and placental vascular tumors.
authors.affiliation: Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Biomedical Sciences Division, St George's University of London, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Iacovella
authors.forename: N
authors.initials: N
authors.lastname: Chandrasekaran
authors.forename: A
authors.initials: A
authors.lastname: Khalil
authors.forename: A
authors.initials: A
authors.lastname: Bhide
authors.forename: A
authors.initials: A
authors.lastname: Papageorghiou
authors.forename: B
authors.initials: B
authors.lastname: Thilaganathan
mesh_terms: D000328:Adult; D001998:Bronchopulmonary Sequestration / Q000196:embryology / Q000503:physiopathology; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005315:Fetal Diseases / Q000503:physiopathology*; D006391:Hemangioma / Q000150:complications / Q000196:embryology; D006801:Humans; D009383:Neoplasms, Vascular Tissue / Q000196:embryology / Q000503:physiopathology*; D010922:Placenta Diseases / Q000503:physiopathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D013125:Spinal Neoplasms / Q000196:embryology; D013724:Teratoma / Q000150:complications / Q000196:embryology
keywords: cardiovascular profile score; fetal tumors; neurodevelopmental outcome; placental tumors