In utero endoscopic devascularization of a large chorioangioma

R. A. Quintero, H. Reich, R. Romero, M. P. Johnson, L. Gonçalves, M. I. Evans

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

Clinically significant chorioangiomas, i.e. those greater than 4 cm in diameter, are associated with an overall fetal loss rate of approximately 40%. Maternal complications may also be present. Most patients diagnosed with chorioangiomas have been managed expectantly. A patient with a large chorioangioma was referred to our institution, with a fetus that was hydropic and showed sonographic signs of overt heart failure. Fetal anemia, marked erythropoiesis and hypoalbuminemia were documented on cordocentesis. The blood supply to the mass consisted of an artery and a vein of 9 mm in diameter. The vascular supply to the tumor was ablated via operative fetoscopy by suture ligation of the arterial supply, after subchorionic dissection of the vessel. The remaining blood supply was electrocoagulated with bipolar cautery. Although the procedure was technically successful, the fetus died on the 3rd postoperative day. This case illustrates ablation of the blood supply of placental chorioangiomas as a potential management alternative for those patients with large chorioangiomas. Early identification and treatment may result in a successful outcome.

Original languageEnglish (US)
Pages (from-to)48-52
Number of pages5
JournalUltrasound in Obstetrics and Gynecology
Volume8
Issue number1
DOIs
StatePublished - Jul 1996

Keywords

  • Chorioangioma
  • Fetal therapy
  • Fetoscopy
  • Placental tumors
  • Prenatal diagnosis

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Reproductive Medicine
  • Acoustics and Ultrasonics
  • Radiological and Ultrasound Technology

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  • Cite this

    Quintero, R. A., Reich, H., Romero, R., Johnson, M. P., Gonçalves, L., & Evans, M. I. (1996). In utero endoscopic devascularization of a large chorioangioma. Ultrasound in Obstetrics and Gynecology, 8(1), 48-52. https://doi.org/10.1046/j.1469-0705.1996.08010048.x