Novel Antenatal Management of a Giant Placental Vascular Tumor - A Case Report

Abstract

Chorioangioma is a benign placental tumor that is usually diagnosed in the second or third trimester of pregnancy by antenatal sonography and is seen in 0.5-1% of pregnancies. While most of the chorioangiomas are asymptomatic, a few cases, especially the ones with large chorioangiomas, may pose challenges both antepartum and intrapartum ranging from maternal complications like polyhydramnios, pre eclampsia, antepartum hemorrhage, mirror syndrome, preterm labor, PPH and fetal complications like fetal anemia, fetal hydrops, fetal growth restriction, intrauterine demise and congestive heart failure. Cases that develop complications at early gestational age may warrant antenatal interventions. However, the decision of termination vs intervention is challenging and case-specific. We report a case of 27 year old Primigravida diagnosed with placental chorioangioma at 28 weeks in a routine growth scan. The patient rapidly developed polyhydramnios in two weeks with early onset FGR. Intravascular glue injection of the feeder vessel was done at 30 weeks. The patient went into spontaneous preterm labor and delivered a girl baby of weight 2.3kgs vaginally at 33 weeks. The case report emphasizes how close antenatal surveillance with timely antenatal interventions can result in favorable maternal and fetal outcomes.