一例胎盘多发性巨大绒毛膜血管瘤导致胎儿水肿并致新生儿死亡。
A case of placental multiple giant chorangioma leading to neonatal death from fetal hydrops.
作者信息
Shiraga Aoi, Ohsuga Takuma, Kawasaki Kaoru, Mogami Haruta, Minamiguchi Sachiko, Mandai Masaki
机构信息
Department of Obstetrics and Gynecology, Kyoto University Hospital, Kyoto, Japan.
Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan.
出版信息
Case Rep Perinat Med. 2022 Dec 19;12(1):20220008. doi: 10.1515/crpm-2022-0008. eCollection 2023 Jan.
OBJECTIVES
Although placental chorangiomas are often asymptomatic, larger tumors (>4-5 cm) can cause various perinatal complications, including polyhydramnios, preterm birth, fetal anemia, fetal hydrops, and intrauterine fetal death. Symptomatic placental chorangiomas are often diagnosed prenatally on ultrasonography as a mass on the fetal side of the placenta.
CASE PRESENTATION
A 37-year-old pregnant woman underwent emergency cesarean delivery at 34 weeks' gestation due to rapidly progressive fetal hydrops leading to fetal dysfunction, resulting in neonatal death. Placental pathology indicated multiple placental giant chorangiomas that occupied 40% of the placenta. Because of the disk shape of the placenta, prenatal diagnosis by ultrasonography was difficult.
CONCLUSIONS
Some placental chorangiomas are difficult to diagnose and lead to fetal hydrops and poor prognosis, even if ultrasonography does not show an obvious mass in the placenta.
目的
尽管胎盘绒毛膜血管瘤通常无症状，但较大的肿瘤（>4 - 5厘米）可导致各种围产期并发症，包括羊水过多、早产、胎儿贫血、胎儿水肿和宫内胎儿死亡。有症状的胎盘绒毛膜血管瘤常在产前超声检查时被诊断为胎盘胎儿侧的肿块。
病例报告
一名37岁孕妇在妊娠34周时因快速进展的胎儿水肿导致胎儿功能障碍而接受急诊剖宫产，导致新生儿死亡。胎盘病理显示多个胎盘巨大绒毛膜血管瘤，占胎盘的40%。由于胎盘呈盘状，超声产前诊断困难。
结论
一些胎盘绒毛膜血管瘤难以诊断，即使超声检查未显示胎盘有明显肿块，也可导致胎儿水肿和预后不良。
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