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Placental chorangiosis associated with markedly elevated maternal chorionic gonadotropin. A case report
Annemarie Stroustrup Smith1, Weei-Yuarn Huang, Geoffrey Wong
1Harvard Medical School, Division of Health Science and Technology, Harvard-Massachusetts Institute of Technology, Departments of Pathology, Obstetrics and Gynecology, and Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Background:
Chorangiosis is a rare abnormality of placental capillary proliferation, associated with hypoxia in utero.
Case:
A 23-year-old primigravida with a total human chorionic gonadotropin (hCG) level of 644,139 IU/L was referred for evaluation. Obstetric ultrasound, pelvic magnetic resonance imaging, computed tomography of the head and chest, and karyotype of the fetus were normal. Complete chorioamniotic separation occurred after amniocentesis. Placental abruption occurred at 33 weeks' gestation, and an emergency cesarean section was performed. Placental histology revealed chorangiosis. The infant was discharged on day 18 of life and did well. Postpartum the hCG level returned to 0.
Conclusion:
Elevated total serum hCG can be associated with chorangiosis. This diagnosis should be considered in cases of elevated hCG when no other anomaly is identified. Patients with elevated hCG should be monitored for placental abruption, a known consequence of chorangiosis.