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[Recurrence of multiple chorio-angiomas: a case-report]
D Gallot1, V Sapin, A-M Beaufrère
1Unité de médecine maternofoetale, maternité de l'Hôtel-Dieu, avenue Vercingétorix, 63003 Clermont-Ferrand, France.
Gynecologie, Obstetrique & Fertilite
|November 19, 2003
Summary
Diffuse chorioangiomatosis, a rare placental condition, presents a high risk of fetal death. This case highlights recurrent instances and emphasizes close monitoring for early detection of fetal complications.
Area of Science:
- Obstetrics and Gynecology
- Perinatology
- Fetal Medicine
Background:
- Diffuse chorioangiomatosis is a rare placental pathology.
- Characterized by multiple chorioangiomas, it poses a significant risk of fetal complications, particularly cardiovascular issues and fetal demise.
- The exact pathophysiology remains unclear, but vascular growth factor over-expression linked to hypobaric-hypoxia is suspected.
Observation:
- This report details a case of recurrent chorioangiomatosis resulting in fetal demise.
- No identifiable risk factors such as high altitude, genetic conditions (e.g., Beckwith-Wiedemann syndrome), or diabetes were present.
- Maternal serum markers (alpha-fetoprotein, beta-human chorionic gonadotropin) and ultrasonographic placental thickness were within normal limits during gestation.
Findings:
- Recurrent diffuse chorioangiomatosis can occur without identifiable risk factors.
- Standard diagnostic markers may not indicate the severity of the condition.
- Close fetal surveillance is crucial in cases with a history of chorioangiomatosis.
Implications:
- Weekly sonographic monitoring is recommended for pregnancies with a history of chorioangiomatosis.
- Early inpatient hospitalization for daily surveillance is advised, especially around the gestational age of previous adverse outcomes.
- Labor induction may be necessary for fetal intolerance or routinely after 37-38 weeks of gestation.