Clinical Outcome in Singleton and Multiple Pregnancies with Placental Chorangioma.
BACKGROUND
Chorangiomas (CAs) are the most common non-trophoblastic tumor-like-lesions of the placenta. Although the clinical significance of small CAs is unknown, the large lesions are often associated with maternal and fetal complications. The aim of our study was to assess the maternal clinical characteristics and neonatal outcome in singleton and multiple pregnancies with placental CA.


METHODS
Among 15742 selected placentas 170 CAs were diagnosed. Pregnancy and neonatal outcomes were analyzed in singleton (n = 121) and multiple (n = 49) pregnancy groups including 121 and 100 neonates, respectively.


RESULTS
The frequency of APGAR score <7 at 5 minutes (p = 0,012), abnormal pulsatility index (p = 0,034), and abnormal blood flow class (p = 0,011) were significantly higher in neonates from singleton compared to multiple pregnancies. Significantly smaller CAs in singleton pregnancies were related to small for gestational age neonates (p = 0,00040) and neonates admitted to the neonatal care unit (p = 0,028). In singleton pregnancies, significantly smaller CAs were associated to maternal preeclampsia (p = 0,039) and larger CAs to multiparity (p = 0,005) and smoking (p = 0,001) groups. The frequency of preeclampsia was high in both singleton and multiple pregnancy groups (41,32% vs 26,53%, respectively), however, the difference did not reach the level of statistical significance.


CONCLUSIONS
A high incidence of preeclampsia in cohort of placental CA might lead to a possible recognition of CAs as potential morphologic indicator of placental hypoxia.


CONCLUSIONS
A more favorable pregnancy outcome in multiple gestations compared to the singleton gestations with CAs might reflect an adaptive mechanism for increased demand of oxygen and associated placental tissue hypoxia in this group.
Section of Perinatal Pathology, Department of Pathology, Karolinska University Hospital Huddinge, Stockholm, Sweden.|Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden.
Meeli
M
Sirotkina
Department of Neurology, Haukeland University Hospital, Bergen, Norway.|Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Konstantinos
K
Douroudis
Section of Perinatal Pathology, Department of Pathology, Karolinska University Hospital Huddinge, Stockholm, Sweden.|Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden.
Nikos
N
Papadogiannakis
Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden.|Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
Magnus
M
Westgren
D000328:Adult; D001034:Apgar Score; D005260:Female; D005865:Gestational Age; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010298:Parity; D010920:Placenta / Q000473:pathology*; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000473:pathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology; D047368:Tumor Burden