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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of placental chorioangioma in an infant who experienced transient congestive heart failure is presented. The mechanism for this heart failure was probably due to excessive left to right shunting of blood across the tumor. Electron-microscopic examination revealed the tumor to be composed of endothelial cells and vascular structures of different types. Immunochemistry revealed the lack of normal placental antigens indicating that these tumors are not composed of trophoblastic tissue.
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PMID:Placental chorioangioma: presentation of a case with electron-microscopic and immunochemical studies. 736 98

Conditions associated with placentomegaly in which the disproportionate placental enlargement is understood include erythroblastosis fetalis, intrauterine infections and chorioangioma. This report suggests that in a pregnancy complicated by a large sacrococcygeal teratoma, placentomegaly results from high-output fetal cardiac failure secondary to the mass acting as an arteriovenous fistula.
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PMID:Placentomegaly due to fetal congestive failure in a pregnancy with a sacrococcygeal teratoma. 743 60

A pregnancy with polyhydramnios and abnormal antepartum fetal heart rate pattern was found to have multiple placental haemangiomas. Multiple placental haemangiomas can give rise to fetal cardiac failure due to a hyperdynamic circulation or fetal anaemia either due to haemodilution or possibly destruction of blood cells in the chorioangioma. Whether fluid restriction with or without diuretics or blood transfusion is the correct form of treatment of neonatal cardiac failure in such a case is discussed.
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PMID:Fetal and neonatal haemodilution associated with multiple placental chorioangioma: case report. 862 91

Clinically significant chorioangiomas, i.e. those greater than 4 cm in diameter, are associated with an overall fetal loss rate of approximately 40%. Maternal complications may also be present. Most patients diagnosed with chorioangiomas have been managed expectantly. A patient with a large chorioangioma was referred to our institution, with a fetus that was hydropic and showed sonographic signs of over heart failure. Fetal anemia, marked erythropoiesis and hypoalbuminemia were documented on cordocentesis. The blood supply to the mass consisted of an artery and a vein of 9 mm in diameter. The vascular supply to the tumor was ablated via operative fetoscopy by suture ligation of the arterial supply, after subchorionic dissection of the vessel. The remaining blood supply was electrocoagulated with bipolar cautery. Although the procedure was technically successful, the fetus died on the 3rd postoperative day. This case illustrates ablation of the blood supply of placental chorioangiomas as a potential management alternative for those patients with large chorioangiomas. Early identification and treatment may result in a successful outcome.
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PMID:In utero endoscopic devascularization of a large chorioangioma. 884 20

Chorioangioma is a vascular tumor of the placenta. Most are small and asymptomatic, whereas the large tumors are clinically significant and often associated with polyhydramnios and fetal heart failure. To prevent fetal loss from these complications, many interventions have been proposed, including intrauterine transfusion in anemic cases and fetoscopic surgery to ablate the feeding vessels. The case presented herein had large chorioangiomas, 8 and 4cm in diameter, associated with polyhydramnios and early signs of hydrops fetalis, diagnosed at 27 weeks gestation. After extensive counseling, we performed alcohol ablation of the feeding vessel of the larger tumor. Signs of fetal heart failure and hydrops fetalis disappeared dramatically. The pregnancy was extended for 2 weeks, followed by premature rupture of the membranes and spontaneous labor at 32 weeks gestation and a surviving female baby, weighing 1360g, was delivered uneventfully. This preliminary experience suggests that alcoholization may be one of the best choices for this condition due to its high efficacy, simplicity, safety and very low cost. To our knowledge, this is the first report using alcoholization for the treatment of hydrops fetalis secondary to chorioangioma.
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PMID:Alcoholization: the choice of intrauterine treatment for chorioangioma. 1207 71

The relationship of large and vascularized chorioangiomas to adverse pregnancy outcome is well recognized. We present a patient with a large placental tumor and signs of impending fetal cardiac failure. The angioarchitecture of the tumor depicted by three-dimensional (3D) power Doppler ultrasound enabled us to accurately diagnose a placental chorioangioma. During the follow-up period, quantitative flow data obtained using 3D power Doppler indicated altered hemodynamics in the tumor and concomitant improvement in the condition of the fetus, enabling us to manage the mother conservatively. Spontaneous delivery occurred at 38 weeks without any complications. This report demonstrates the potential value of 3D power Doppler in prenatal diagnosis and monitoring of pregnancies complicated by large, vascularized chorioangioma.
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PMID:Quantitative three-dimensional power Doppler ultrasound predicts the outcome of placental chorioangioma. 1528 61

Chorangioma has been referred to as a hamartoma-like, or a hyperplastic capillary lesion, rather than a true neoplasm. Its incidence is 1 in 100 placentas. In chorangiomas larger than 4 cm, there can be significant effects on the hemodynamic and circulatory processes of the fetus, leading to grave clinical consequences, such as polyhydramnios and fetal heart failure. Chorangiomas can show various histopathologic pictures, ranging from vascular to cellular, and can undergo degenerative changes. They can be diagnosed prenatally by ultrasound, color Doppler imaging, and magnetic resonance imaging (MRI). Chorangioma must be differentiated from other villous capillary lesions, namely, chorangiomatosis and chorangiosis. They have overlapping similarities with chorangioma, and have clinical implications. Chorangiomatosis has been associated with negative fetal outcomes such as intrauterine growth retardation (IUGR) and preeclampsia. Chorangiosis is associated with maternal diabetes mellitus. Another rarer differential is chorangioma with trophoblast proliferation ("chorangiocarcinoma," a probable misnomer), a rare proliferation of trophoblastic tissue seen in the vicinity of otherwise benign chorangioma. Treatment modalities of chorangioma include endoscopic devascularization, alcoholic ablation, and interstitial laser coagulation. In this article, we will review the clinical and pathologic picture of chorangioma as well as treatment, and discuss its main differentials.
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PMID:Chorangioma and related vascular lesions of the placenta--a review. 2059 43

We describe a case of a large chorioangioma diagnosed at 18 weeks' gestation. Because of advanced fetal heart failure at 23 weeks' gestation, embolization of the chorioangioma's vessels was performed by percutaneous injection of Glubran 2 surgical glue. There was no immediate secondary effect of treatment. Devascularization was complete and durable. Signs of fetal cardiac failure normalized after 1 month and a healthy infant was delivered at 38 weeks. To our knowledge this is the first reported case of perinatal survival after successful embolization of a chorioangioma using tissue glue.
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PMID:Antenatal embolization of a large chorioangioma by percutaneous Glubran 2 injection. 2073 57

Large placental chorioangiomas (>4 cm) can precipitate severe polyhydramnios, fetal anemia, growth restriction, high-output cardiac failure, hydrops, and fetal demise. We report a case of a large chorioangioma that was treated in a stepwise fashion with amnioreduction to ameliorate maternal discomfort, followed by fetoscopic laser ablation of the feeding vessels after rapid evolution of heart failure. Although amnioreduction was helpful in improving maternal symptoms, we suspect that the drop in intrauterine pressure from the amniotic fluid decompression may have resulted in increased tumor perfusion, thereby promoting fetal deterioration due to a 'steal' phenomenon. Close scrutiny of the fetal status via ultrasound is required, particularly if amnioreduction is necessary, and definitive treatment should be considered once early signs of heart failure develop. Fetoscopic laser ablation of the feeding vessels is a feasible definitive treatment of a large chorioangioma in cases in which perfusion of the tumor is via a superficial nonterminus umbilical artery. Future reports should describe the anatomy of the blood supply to the chorioangioma, in the hopes that further guidelines for surgical candidacy may be established.
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PMID:Fetoscopic laser photocoagulation of feeding vessels to a large placental chorioangioma following fetal deterioration after amnioreduction. 2208 70

Placental chorioangioma is an angioma arising from chorionic tissue. Fetal thanatophoric dysplasia is a lethal skeletal dysplasia due to mutation of fibroblast growth factor receptor 3 gene. These two conditions are rare and their coexistence in a given fetus is even rarer. We present a case of a fetus with thanatophoric dysplasia having high-output cardiac failure due to a large placental chorioangioma.
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PMID:High-output cardiac failure in a fetus with thanatophoric dysplasia associated with large placental chorioangioma: case report. 2250 20


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