Chorioangioma placentae and feto-maternal transfusion; a report of two cases

doi:10.1016/0028-2243(89)90084-1

European Journal of Obstetrics & Gynecology and Reproductive Biology

Volume 33, Issue 1, October 1989, Pages 95-98

https://doi.org/10.1016/0028-2243(89)90084-1 Get rights and content

Abstract

Chorioangioma (CA) is found in about 1% of all placentas. Here we report cases of CA: one associated with intra-uterine fetal death, and the other with feto-maternal transfusion resulting in severe anaemia of the child. Feto-maternal transfusion through a CA could, in suspected cases, be diagnosed by s-AFP, one-minute alkali-denaturation test and perhaps ultrasound of the placenta. Intra-uterine death of the child could then be prevented by Caesarean section.

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Citation Excerpt :
The larger number of cases and controls in this study made statistical analysis possible with correlation between placental features and blood loss also being investigated. Particularly noteworthy is the case with a chorangioma comprising 40% of the placental weight associated with FMH (case 3); which has only rarely been reported in the literature [19,20]. Another autopsy case of FMH (case 2) revealed avascular villi involving 30% of the placental parenchyma with a hypocoiled cord in a small for gestational age placenta.
Feto-maternal hemorrhage (FMH) is not an uncommon event during pregnancy with important clinical implications for both maternal and fetal outcomes. The diagnosis is often made using Kleihauer-Betke (KB) test. As FMH occurs transplacentally, examination of the placenta may contribute to the diagnosis of FMH. This retrospective case-control study aims to examine the placental features associated FMH in patients with known positive KB test results. When compared with KB negative placentas (n = 88), KB positive placentas (n = 49) had significantly higher incidence of pallor (6/49 vs 0/88, p = 0.0017), IVT (11/49 vs. 5/88, p = 0.0032) and nRBCs (12/49 vs. 4/88, p = 0.0008). Autopsy cases with fetal or neonatal death due to FMH, (n = 13) compared to a cohort of 162 placentas associated with other, non-FMH causes of death also had significantly higher frequency of pallor (5/13 vs 0/162, p < 0.0001), IVT (6/13 vs 24/162, p = 0.011) and nRBCs (11/13 vs 67/162, p = 0.003). Pallor and nRBC were also associated with higher volume of FMH. Placental parenchymal pallor, intervillous thrombi and presence of nRBCs are significantly associated with documented FMH in both normal pregnancies and pregnancies associated with fetal or neonatal death. The presence of these findings, especially in combination, may suggest the need for maternal KB testing to rule out FMH and neonatal monitoring and/or intervention.
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Case reportChorioangioma placentae and feto-maternal transfusion; a report of two cases

Abstract

Am J Obstet Gynecol

Vascular tumours of the placenta

Obstet Gynecol Surv

Non-trophoblastic tumor of the placenta

An improved method for the estimation of small quantities of alkali-resistant hemoglobin in blood

Scand J Clin Lab Inv.

Case report
Chorioangioma placentae and feto-maternal transfusion; a report of two cases