Chorioangioma: a single tertiary care center retrospective study

Objectives: Chorioangioma represents a challenge due to the rarity of the condition, paucity of sufficient manage-ment guidelines, and controversies regarding the best invasive fetal therapy option; most of the scientific evi-dence for clinical treatment has been limited to case reports. The aim of this retrospective study was to review the natural antenatal history, maternal and fetal compli-cations, and therapeutic modalities used in pregnancies complicated with placental chorioangioma at a single Center.Methods: This retrospective study was conducted at King Faisal Specialist Hospital and Research Center (KFSH & RC) in Riyadh, Saudi Arabia. Our study population included all pregnancies with ultrasound features of chorioangioma, or histologically confirmed chorioangiomas, between January 2010 and December 2019. Data were collected from the patients' medical records, including the ultrasound reports and histopathology results. All subjects were kept anonymous; case numbers were used as identifiers. Data collected by the investigators were entered into Excel worksheets in an encrypted format. A MEDLINE database was used to retrieve 32 articles for literature review.Results: Over a 10-year period between January 2010 and December 2019,11 cases of chorioangioma were identified. Ultrasound remains the gold standard for diagnosis and follow-up of the pregnancy. Seven of the 11 cases were detected by ultrasound, allowing proper fetal surveillance and antenatal follow-up. Of the remaining six patients, one underwent radiofrequency ablation, two underwent intrauterine transfusion for fetal anemia due to placenta chorioangioma, one had vascular embolization with an adhesive material, and two were managed conservatively until term with ultrasound surveillance.Conclusions: Ultrasound remains the gold standard modality for prenatal diagnosis and follow-up of preg-nancies with suspected chorioangiomas. Tumor size and vascularity play a significant role in the development of maternal-fetal complications and the success of fetal interventions. To determine the superior modality of fetal intervention mandates more data and research; never-theless, Fetoscopic Laser Photocoagulation and emboliza-tion with adhesive material seem to be a lead choice, with reasonable fetal survival.

Automated summary

This retrospective study aimed to review the natural antenatal history, maternal and fetal complications, and therapeutic modalities used in pregnancies complicated with placental chorioangioma. The study concluded that ultrasound remains the gold standard for prenatal diagnosis and follow-up, and more data and research are needed to determine the superior modality of fetal intervention.