Prenatal Therapy of Large Placental Chorioangiomas: Case Report and Review of the Literature

被引:22
作者
Hosseinzadeh, Pardis [1 ,2 ]
Shamshirsaz, Alireza A. [1 ,2 ,5 ]
Javadian, Pouya [1 ,2 ]
Espinoza, Jimmy [1 ,2 ,6 ]
Gandhi, Manisha [1 ,2 ]
Ruano, Rodrigo [1 ,2 ,5 ]
Cass, Darrell L. [3 ,4 ]
Olutoye, Oluyinka A. [3 ,4 ]
Belfort, Michael A. [1 ,2 ,5 ]
机构
[1] Baylor Coll Med, Dept Obstet & Gynecol, Div Maternal Fetal Med, Houston, TX 77030 USA
[2] Texas Childrens Hosp, Houston, TX 77030 USA
[3] Baylor Coll Med, Texas Childrens Fetal Ctr, Div Pediat Surg, Houston, TX 77030 USA
[4] Baylor Coll Med, Michael E DeBakey Dept Surg, Houston, TX 77030 USA
[5] Baylor Coll Med, Dept Obstet & Gynecol, Div Fetal Intervent, Houston, TX 77030 USA
[6] Baylor Coll Med, Dept Obstet & Gynecol, Div Womens & Fetal Imaging, Houston, TX 77030 USA
来源
AJP REPORTS | 2015年 / 5卷 / 02期
关键词
chorioangioma; laser ablation; nonimmune hydrops fetalis; systematic review;
D O I
10.1055/s-0035-1558829
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To review techniques and outcomes of different prenatal treatments for large placental chorioangiomas. Study Design Presentation of a case of laparoscopic-assisted laser coagulation and a systematic review of the literature for articles related to intervention for placental chorioangioma. Results A total of 37 cases of definitive (n = 23) and supportive therapy ( n = 14) were evaluated, including one case treated in our center. Approximately 35% of the patients had a spontaneous preterm delivery in definitive treatment group versus 36% in the supportive group. The infant survival rates were 65 and 71% in the two groups, respectively. We further compared the two types of laser ablation (fetoscopic [n = 10] and interstitial [n = 4]). Approximately 30% of the patients in the fetoscopic and 25% in interstitial group, had a spontaneous preterm delivery. Survival rates were 60 and 100% in fetoscopic and interstitial groups, respectively. Conclusion Laser ablation and embolization of chorioangiomas via minimally invasive approach may prevent or reverse fetal hydrops due to high cardiac states. However, further studies are needed to refine the appropriate selection criteria that will justify the risk of this invasive in utero therapy for chorioangiomas.
引用
收藏
页码:E196 / E202
页数:7
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