A 25-year-old primigravida, on scan at 27 weeks, was diagnosed with a large vascular placental chorioangioma ( Figure 1 ). The different intrauterine treatment options such as ablation of vessels by laser or glue embolization seemed difficult, as there were multiple feeders inside the tumor draining into a large feeding vessel ( Figure 2 ); moreover, it was in close proximity to the umbilical cord, subjecting it to a higher risk of fetal demise. We managed the pregnancy conservatively with serial scans. The tumor subsequently increased in size because of the development of an intraplacental component with increased vascularity ( Figure 3 ). At 32 weeks, the features of hyperdynamic circulation, including elevated middle cerebral artery Doppler peak systolic velocity were detected, and at 33+5 weeks, the mother complained of reduced fetal movements. The family refused intrauterine blood transfusion and preferred delivery after antenatal steroids. A female baby weighing 1.8 kg was delivered. The placenta was removed with some difficulty as it adhered to the previous myomectomy scar. A histopathology of the placental mass ( Figure 4 ) confirmed the diagnosis as chorioangioma.
Three-dimensional color Doppler acquisition of a highly vascular giant placental chorioangioma
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