Kounsal Avin, Saini Divya, Podder Vivek, Mehta Chetan, Suthar Pokhraj P
Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, USA.
Department of Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
Cureus. 2023 Jun 22;15(6):e40790. doi: 10.7759/cureus.40790. eCollection 2023 Jun.
A 25-year-old primigravida presented at 26 weeks of gestation by dates, the first time for the routine antenatal checkup. No histories were suggestive of pregnancy-induced hypertension (PIH) and edema. On physical examination, pallor was present with microcytic hypochromic anemia. Raised beta-human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) levels were present. Ultrasonography revealed triples with two thin echogenic intertwining membranes. Anomaly scan did not reveal any abnormality in fetuses. The placenta showed a large oval hypoechoic mass arising from its edge and bulge into the amniotic fluid. A central feeding vessel with a branching pattern and pulsatile color flow like that of the umbilical artery is noted on the color Doppler. She was spontaneously preterm delivered vaginally at 28 weeks of gestation. All three fetuses were stillborn. Histopathological diagnosis of angiomatous chorioangioma was confirmed. This case classically represents a grave complication of the large chorioangioma.
一名25岁初产妇，根据末次月经计算孕26周，首次进行常规产前检查。无妊娠高血压综合征（PIH）及水肿病史。体格检查发现面色苍白，伴有小细胞低色素性贫血。β-人绒毛膜促性腺激素（HCG）和甲胎蛋白（AFP）水平升高。超声检查显示三胎妊娠，有两层薄的强回声交织膜。畸形扫描未发现胎儿有任何异常。胎盘显示从其边缘出现一个大的椭圆形低回声肿块，并突入羊水中。彩色多普勒显示有一条中央供血血管，呈分支状，有类似脐动脉的搏动性血流信号。她于孕28周时自然早产，经阴道分娩。三个胎儿均为死产。组织病理学诊断确诊为血管瘤样绒毛膜血管瘤。该病例典型地代表了巨大绒毛膜血管瘤的严重并发症。
