Polyhydramnios with Spontaneous Remission Associated with Large Placental Chorioangioma - Case Report

Chorioangioma is a nontrophoblastic placental tumor with an incidence of 1% of births [1, 2]. The small chorioangiomas are asymptomatic and highlighted in the postpartum examination of the placenta [3]. We present the case of a 27-year-old patient, pregnant for the first time, who performed a routine obstetric ultrasound at 19-20 weeks of pregnancy (Fig. 1) was found to have polyhidraminos with Phellan Index 25 cm(centimeters), associated with a placental tumor mass-70.21mm(millimeters) x 66, 97mm (Fig. 1), suggestive of placental chorioangioma. Ultrasound examination of fetal morphology did not reveal fetal abnormalities. The particularity of the case was given by the spontaneous remission of the polyhydramnios at 30-31 weeks of pregnancy (Fig. 2), but with the persistence of the placental tumor mass until the end of pregnancy (Fig. 3). The evolution of pregnancy after 30 weeks was normal. The pregnancy was ended at term, 40w1d, by C-section for CPD (cephalo-pelvic disproportion) with a live, macrosome fetus (who wheighs 4400 grams). At the placenta level (which wheighs 1000 grams), the tumor mass was described in ultrasound (Fig. 4, 5). Histopathological examination confirmed placental chorioangioma with old infarctional lesions (Fig. 6, 7). We have analyzed in the literature other cases reported with large placental chorioangioma and we have found the frequent association of this tumor with a number of complications in evolution of pregnancy: preeclampsia, fetal hydrops, intrauterine growth restriction, premature delivery, intrauterine death of the fetus, acute fetal distress, anemia and thrombocytopenia of the newborn, fetal abnormalities, fetal heart failure. [4, 5, 6, 7] We believe that the spontaneous remission of the polyhydramnios by infarcting of the chorioangioma at the end of the second trimester allowed the normal course of pregnancy to occur, even with a macrosome fetus.