Placental chorioangiomatosis -ahigh risk pregnancy

Summary: Acaseofdiffuse chorioangiomatosis leadingto fetal hydrops,disseminatedintravascular coagulopathy with massive umbilical vein thrombosis andfetal death is described. Although rare, thisbenign mesenchymatous malformation ofthe placenta should be kept in mind as a possible cause of neonatal morbidity. Prenatal diagnosis could prevent fetal death.Introduction Chorioangioma is themostcommon neoplasmof the placenta. Althoughgenerally small, being only a fewcm in diameter, it occurswith a frequencyofup to 1%of all deliveries (Fox, 1978), and is clinically insig-nificant. However, larger chorioangiomata are rarer and can lead to symptoms. Hydramnios, toxaemia,fetal distress, anaemia, fetal hydrops and neonataldeath have been associated with large chorioan-giomatain one of3500-9000deliveries. Anevenrarer manifestation, chorioangiomatosis, is defined as a diffuse proliferation ofthe placental capillaries.We present a rare case of chorioangiomatosisleadingtotheinfant'sdeathwithhydropsandmassiveumbilical vein thrombosis, associated with dissemin-ated intravascular coagulopathy.CasereportAthirty year old P3 G4womanwas admitted in the39thweekofherpregnancybecause ofanaemia. Shehad gained 22kg during the pregnancy. Previouspregnancies were normal. Her abdomen was verydistended,andbloodpressurewas110/70mmHg.Shewas not in active labour. Ultrasonic examinationrevealedpolyhydramnioswithenlargedfetalheartandliver. Theplacenta washypertrophic, and over 5cmthick. Fetal echography showed spontaneous de-celerations