Unidad de Gestión Clínica de Genética, Reproducción y Medicina Fetal, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
BMC Pregnancy Childbirth. 2012 Jul 28;12:72. doi: 10.1186/1471-2393-12-72.
Giant placental chorioangiomas have been associated with a number of severe fetal complications and high perinatal mortality.
We report a case of giant chorioangioma with fetal hydrops, additionally complicated by severe anemia, mild cardiomegaly with hyperdinamic heart circulation and maternal mirror syndrome. Intrauterine blood transfusion and amniodrainage was performed at 29 weeks. Worsening of the fetal and maternal condition prompted us to proceed with delivery at 29 + 5 weeks. The newborn died 3 hours later due to pulmonary hypoplasia and hemodynamic failure. Maternal course was favourable, mirror syndrome resolved in the second day and the patient was discharged four days following delivery.
In the case described here, fetal condition got worse despite of the anemia correction and amniodrainage. Our outcome raises the issue whether additional intrauterine clinical intervention, as intersticial laser, should have been performed to stop further deterioration of the fetal condition when progressive severe hydrops develops.
巨大胎盘绒毛膜血管瘤与许多严重的胎儿并发症和围产儿死亡率高有关。
我们报告了一例巨型绒毛膜血管瘤伴胎儿水肿的病例，此外还伴有严重贫血、轻度心肌扩张伴高动力性心脏循环和母体镜像综合征。在 29 周时进行了宫内输血和羊水引流。胎儿和母亲的病情恶化促使我们在 29+5 周时进行分娩。新生儿由于肺发育不良和血液动力学衰竭，3 小时后死亡。母亲的病情良好，镜像综合征在第二天得到缓解，患者在分娩后第四天出院。
在本例中，尽管纠正了贫血并进行了羊水引流，但胎儿情况仍恶化。我们的结果提出了一个问题，即在进行性严重水肿发展时，是否应该进行额外的宫内临床干预，如间质激光，以阻止胎儿病情进一步恶化。
