Vanishing Non-immune Hydrops in Giant Chorioangioma of Placenta

Abstract

Giant Chorioangioma of placenta is a rare nontrophoblastic tumour of placenta. It may lead to various maternal and foetal complications like massive antepartum haemorrhage, sudden intrauterine foetal demise and non-immune hydrops, although in few cases mother and the foetus remain unaffected. This report is of a 35-year-old G3P1L1A1, presented to hospital at 32 weeks gestation with pain abdomen followed by watery discharge from vagina. Ultrasonography at 30 weeks revealed a huge mass on anterior wall with placenta on posterior wall of uterus although her previous antenatal sonography did not reveal any abnormality either in the foetus or in placenta. Diagnosis of preterm rupture of membranes was confirmed. Hence, she was kept on conservative management; received antibiotics and steroids for foetal lung maturity. Subsequently, the foetus developed mild, steady non-immune hydrops probably due to high output cardiac failure as Values of Middle Cerebral Artery’s Peak Systolic Velocity (MCA-PSV) were within normal limits. Biophysical profile and nonstress test were normal. Guarded foetal prognosis was given due to non-immune hydrops but she delivered a normal female baby with good Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score with huge chorioangioma of placenta. Although rare, chorioangiomas of placenta should be kept in differential diagnosis of non-immune hydrops that needs regular foetal surveillance and timely intervention in affected foetuses to increase survival after birth.

Keywords

• nontrophoblastic tumour of placenta
• polyhydramnios
• preterm labour
• preterm rupture of membranes