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Interventional embolization of placental hemangioma for pregnant women over 26 weeks of pregnancy

Báo Sài Gòn Giải phóngBáo Sài Gòn Giải phóng29/08/2023


SGGPO

On the morning of August 29, Tu Du Hospital (HCMC) successfully performed a cesarean section for the pregnant woman VTTN (35 years old, living in Tay Ninh ) after a period of intervention to embolize the placental hemangioma when the pregnancy was only 26.5 weeks.

The doctor is performing a cesarean section on a pregnant woman.
The doctor is performing a cesarean section on a pregnant woman.

Previously, the patient was diagnosed with a placental hemangioma at 17 weeks of pregnancy and the tumor continued to grow. At 26 weeks, the pregnant woman was consulted by Tu Du Hospital with Children's Hospital 1 and diagnosed with a placental hemangioma causing anemia, fetal edema, and fetal distress...

According to Dr. Trinh Nhut Thu Huong, Head of the Prenatal Care Department, Tu Du Hospital, the patient's placental hemangioma is large. Without intervention, the hemangioma will cause many complications (30% will cause premature labor and the mortality rate is up to more than 50%). The hospital also cannot deliver the baby at 26 weeks.

The pregnant woman was assigned to have intervention to block the blood vessels that feed the tumor. This procedure was performed at Tu Du Hospital, in coordination with the teams from Tu Du Hospital and Children's Hospital 1 at 26.5 weeks of pregnancy. The fetus then received a blood transfusion.

10 days ago, the mother was hospitalized for close monitoring because of a large, thick, sticky placental hematoma and the risk of postpartum hemorrhage. Furthermore, the mother had an old surgical scar...

On the morning of August 29, when the fetus was 37.5 weeks old, Tu Du Hospital performed a cesarean section for the mother. Anticipating the risk of hemorrhage, the medical team controlled the bleeding within 2 minutes after the surgery, and the baby was born well-developed, weighing 2.9 kg.

According to Dr. Tran Ngoc Hai, Director of Tu Du Hospital, this is the first successful case of selective endovascular embolization to treat a placental hemangioma in Vietnam, performed at 26.5 weeks of pregnancy. Because it was the first intervention, everyone was nervous because of the risk of bleeding, premature placental abruption, fetal death, etc.

Placental hemangioma is a non-trophoblastic vascular tumor of the placenta with an incidence of only about 1%. The incidence of large placental hemangioma (more than 4.5 cm) is rare, about 1/3,500 - 1/9,000/case. If the placental hemangioma is small, there may be no abnormal symptoms.

However, when the placental hemangioma is large (4 - 5 cm), it can cause complications that can affect placental circulation. Complications of large placental hemangioma include: fetal hydrops (14% - 28% of cases); fetal anemia; premature birth; fetal heart failure; fetal growth retardation; stillbirth.



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