Barros Andreia, Freitas Ana Cristina, Cabral António Jorge, Camacho Maria Carmo, Costa Edite, Leitão Henrique, Nunes José Luis
Department of Pediatrics, Funchal Central Hospital, Funchal, Portugal.
BMJ Case Rep. 2011 May 16;2011:bcr0220113880. doi: 10.1136/bcr.02.2011.3880.
Giant choriangiomas are rare placental tumours, associated with a high prevalence of pregnancy complications and a poor perinatal outcome. Neonatal consequences include severe microangiopathic haemolytic anaemia, thrombocytopaenia and hydrops. The associated high perinatal death rate (30-40%) has led to a number of prenatal therapeutic interventions with limited success in most cases. The authors present a case of non-immune fetal hydrops caused by a giant chorioangioma, diagnosed at 27 weeks of gestational age. Despite tocolytic therapy, the baby was born prematurely (28 weeks of gestational age) and required transfusion of blood derivatives, intensive phototherapy and exchange transfusion. She had an uncomplicated recovery and was discharged home in the second month of life. The authors emphasise the need to consider chorioangioma as a cause of non-immune fetal hydrops and microangiopathic haemolytic anaemia.
巨大绒毛膜血管瘤是一种罕见的胎盘肿瘤,与妊娠并发症的高发生率及围产期不良结局相关。新生儿的后果包括严重的微血管病性溶血性贫血、血小板减少和水肿。相关的高围产期死亡率(30%-40%)已促使人们采取了多种产前治疗干预措施,但在大多数情况下成效有限。作者报告了一例由巨大绒毛膜血管瘤引起的非免疫性胎儿水肿病例,该病例在孕27周时被诊断出来。尽管进行了宫缩抑制治疗,婴儿仍早产(孕28周),并需要输注血液制品、强化光疗和换血治疗。她恢复过程顺利,在出生后第二个月出院回家。作者强调,需要将绒毛膜血管瘤视为非免疫性胎儿水肿和微血管病性溶血性贫血的一个病因。