- What is Chorioangioma?
A chorioangioma is a benign tumor made up of too many blood vessels that form in the placenta. These vessels may be connected to the baby via the umbilical cord. Although development of a chorioangioma during pregnancy is not uncommon, large chorioangiomas are rare. Larger masses can be associated with pregnancy complications, including:
- Maternal and fetal clotting problems
- Intrauterine growth restriction
- Premature delivery
- Fetal heart failure
- Hydrops (excess fluid) affecting the fetus
A chorioangioma is thought to arise as a malformation of the tissue of the placenta. As it grows, the tumor acts as a shunt between fetal arteries and veins leading to progressive heart failure in the baby if the condition is left undetected.
- Prenatal Diagnosis of a Chorioangioma
Chorioangiomas tend to occur on the fetal side of the placenta, close to the umbilical cord insertion, and protrude into the amniotic cavity. One may be detected after a routine blood test shows abnormally high alpha fetoprotein levels in the mother’s blood. High-definition ultrasound technology may also detect a mass.
To better assess the pattern of blood flow within the tumor and determine the extent of any blood flow restrictions, our physicians may perform a non-invasive Doppler umbilical study as well. A large chorioangioma may present with an unusually decreased blood flow on color Doppler images.
- How We Treat Chorioangioma
Most pregnancies with a chorioangioma do not require immediate treatment while the baby is in the womb. Because many of the tumors are asymptomatic, they may be monitored throughout a woman’s pregnancy using ultrasound. Some chorioangiomas may even diminish on their own during the course of pregnancy. In rare cases of large chorioangiomas (defined as larger than 4 centimeters), the baby may need faster treatment.
The maternal fetal medicine physicians and surgeons of Fetal Care Center Dallas are skilled to provide a number of treatment approaches to address a chorioangioma.
This may be necessary if there is ultrasound evidence that your baby has anemia (low red blood cell count). Platelet transfusion may also be necessary. Intrauterine transfusion involves transfusing blood through a needle inserted through your abdomen and uterus and into your baby’s umbilical cord to treat the anemia while your baby is still in utero. The procedure is performed under ultrasound guidance for precise insertion.
Amnioreduction is a procedure in which a needle is inserted into the amniotic cavity using ultrasound guidance to remove excess fluid with the purpose of decompressing the womb to prevent preterm delivery. This procedure may be necessary if the excess amniotic fluid causes preterm contractions and/or a shortened cervix.
Surgical Fetoscopy and Laser Ablation
A minimally invasive fetoscopic procedure may be performed under ultrasound guidance to aid in laser closure of the vessels feeding the tumor. The abnormal blood vessels are sealed and prevented from further enlarging and causing blood-flow restrictions.
- Outlook for Babies with Chorioangioma
The overall prognosis for babies diagnosed with chorioangiomas is somewhat dependent on the presence or development of hydrops. In general, small tumors are considered to have little effect on fetuses and subsequent newborns.