Mubiayi N, Cordonnier C, Le Goueff F, Subtil D, Devisme L, Decocq J, Delahousse G, Puech F
Clinique de Gynécologie-Obstétrique et Néonatologie, Hôpital Jeanne-de-Flandre, CHRU de Lille.
J Gynecol Obstet Biol Reprod (Paris). 2002 Apr;31(2 Pt 1):187-92.
Placental chorioangioma is a benign vascular tumor found in about 1% of pregnancies at routine histological examination of the placenta. The large placental tumor may cause serious fetal complications. We report 4 cases of placental chorioangioma diagnosed during the second trimester. Three pregnancies with rapidly growing tumors measuring more than 4 cm led to fetal hydrops and perinatal death despite thoracocentesis and cesarean delivery at 33 weeks (1 case) and repeated amniodrainage (1 case). The only surviving infant presented with a 3.3cm tumor which grew progressively to 8 cm at 38 weeks and did not induce polyhydramnios or hydrops. Although aggressive prenatal management of placental chorioangioma has been reported using amniodrainage, intrauterine transfusions, embolization, or ligation of the tumor vessel supply, prognosis remains poor for large tumors and largely depends on fetal hemodynamic tolerance.
胎盘绒毛膜血管瘤是一种良性血管肿瘤,在胎盘常规组织学检查中,约1%的妊娠中可发现。巨大的胎盘肿瘤可能导致严重的胎儿并发症。我们报告4例在孕中期诊断出的胎盘绒毛膜血管瘤。3例肿瘤迅速生长且直径超过4cm的妊娠,尽管在33周时进行了胸腔穿刺和剖宫产(1例)以及反复羊水引流(1例),仍导致胎儿水肿和围产期死亡。唯一存活的婴儿出生时肿瘤为3.3cm,在38周时逐渐增大至8cm,未引发羊水过多或水肿。尽管已有报道采用羊水引流、宫内输血、栓塞或结扎肿瘤血管供应等积极的产前管理方法来治疗胎盘绒毛膜血管瘤,但对于巨大肿瘤,预后仍然很差,且很大程度上取决于胎儿的血流动力学耐受性。