Placental chorio-angiomas are rare benign vascular tumours of the placenta which are usually small and clinically insignificant, but large lesions can cause serious fetal complications such as anaemia, hydrops fetalis and an adverse perinatal outcome. We report the case of a 29-year-old multigravida diagnosed at 28 weeks' gestation with a large placental chorioangioma accompanied by sonographic evidence of fetal anaemia and hydrops fetalis. Despite two intra-uterine transfusions which led to partial improvement, the hydrops persisted, necessitating a preterm caesarean delivery at 31 weeks. The newborn required prolonged neonatal intensive care for respiratory distress, hydrops, thrombocytopenia and bronchopulmonary dysplasia, but there was satisfactory growth and neurodevelopment at 12 months of age. This case highlights the importance of early diagnosis and timely, individualised fetal therapy in managing large chorio-angiomas, and underscores how coordinated care through public-private partnership in a resource-limited setting can support effective continuity of antenatal and neonatal management, leading to a favourable perinatal outcome.
Kommalur et al. (Mon,) studied this question.