羊水過多をきたし，胎児心不全に至った18cmの巨大胎盤血管腫の1例

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  • A case of giant chorioangioma complicated with polyhydramnios and congenital fetal heart failure
  • ショウレイ ホウコク ヨウスイ カタ オ キタシ,タイジ シンフゼン ニ イタッタ 18cm ノ キョダイ タイバン ケッカン シュ ノ 1レイ

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Chorioangioma is the most common benign tumor of the placenta. However, chorioangioma larger than 15 cm are extremely rare. Studies have shown that a larger size of chorioangioma is associated with an increased likelihood of severe perinatal complications such as polyhydramnios and preterm delivery in mothers and heart failure, anemia, non-immune hydrops fetalis and intrauterine growth restriction in fetuses.Here, we report a case of giant chorioangioma complicated with polyhydroamnios followed by fetal heart failure at 29 weeks of gestation. A 17-year-old primigravida was transferred to our hospital for polyhydroamnios and frequent uterine contraction at 27 weeks of gestation. Color Doppler ultrasonography showed a hypervascular tumor (size, 91 x 63 mm) at the edge of the placenta. The fetus was carefully evaluated with ultrasonography, and the fetal heart rate was monitored; cesarean delivery was performed at 29 weeks of gestation due to nonimmune hydrops fetalis and fetal heart failure with cardiothoracic area ratio (CTAR) and inferior vena cava preload index (IVC-PLI) elevation. The size of the placental tumor increased to 18 x 13 cm at 29 weeks of gestation. The infant was discharged in fair condition at 96 days of age. Careful observation of the fetus for complications due to the giant chorioangioma and prompt treatment after diagnosis of fetal heart failure contributed to good prognosis of the infant. Thus, initiating appropriate treatment is important to manage cases of large chorioangiomas complicated with fetal heart failure during pregnancy. [Adv Obstet Gynecol, 64(4) : 490-494, 2012(H24.11)]

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