On the afternoon of August 29, Dr. Tran Ngoc Hai, Director of Tu Du Hospital (HCMC), said that for the first time, the hospital successfully intervened in a placental hemangioma, saving the life of a 26.5-week-old fetus in the womb.
This is the result of the obstetrics and pediatrics model that the city's health sector has recently implemented, and is also the first successful endovascular intervention to treat placental hemangioma in Vietnam.
Accordingly, the fetus is the child of Ms. VTTN (35 years old, living in Tay Ninh ). Ms. N. discovered a placental hemangioma when she was 17 weeks pregnant. After that, she was monitored and when the pregnancy reached 26 weeks, the doctor at Tu Du Hospital consulted with Children's Hospital 1. As a result, the placental hemangioma grew to a size of 59x75mm (as big as a bowl), causing anemia, fetal edema, fetal failure...
The doctor intervened to block the blood vessels that fed the tumor when the fetus was 26.5 weeks old.
Doctors say that if left untreated, hemangiomas will cause complications. Of these, 30% cause premature labor and more than 50% cause death.
Tu Du Hospital performed a cesarean section for Ms. N., the baby was born healthy, weighing 2.9kg.
To save the fetus, the mother was prescribed intervention to block the blood vessels feeding the tumor when the fetus was 26.5 weeks old, weighing 600-700 grams. After that, the fetus received a blood transfusion. As a result, the anemia gradually decreased, the fetus grew appropriately. However, 10 days before being admitted to the hospital, Ms. N. was hospitalized for monitoring because the placental hematoma was large, thick, sticky and at risk of postpartum hemorrhage, and the mother had an old surgical scar.
On the same morning, when the fetus was 37.5 weeks old, Tu Du Hospital performed a cesarean section for Ms. N., and the baby was born healthy, weighing 2.9 kg. Notably, the team controlled the bleeding within 2 minutes after the surgery.
According to Dr. Tran Ngoc Hai, this is the first case of selective endovascular embolization to successfully treat placental hemangioma in Vietnam. Therefore, the entire team was worried about the old surgical wound, postpartum hemorrhage due to thick placenta, wide adhesion area, risk of bleeding, premature placental abruption, fetal death... However, the surgery was successful.
Placental hemangioma is a vascular tumor with an incidence of only about 1%. The incidence of placental hemangioma of 4–5 cm is rare, about 0.29% – 0.11%.
If the hemangioma is small, there may be no abnormal symptoms. However, when the placental hemangioma is large, 4-5 cm, it can cause complications such as affecting placental circulation.
Complications of large placental hemangioma include: fetal hydrops (accounting for 14%-28% of cases); fetal anemia; premature birth; fetal heart failure; fetal growth retardation; stillbirth.
Placental vascular occlusion is a modern endovascular intervention technique of the placenta. Currently, in the world, there are methods to treat large placental hemangiomas such as: endovascular intervention to block placental blood vessels with chemicals, alcohol, vascular laser...
Selective endovascular embolization for the treatment of placental hemangioma is a high-tech intervention guided by ultrasound, more precise in selecting blood vessels than laser technique, less toxic than intravascular alcohol injection and does not cause bleeding complications after needle removal.
Some reports in the world use many chemicals to cause embolism such as Histoacryl... Interventional techniques need to accurately determine the blood vessels that feed the placental hemangioma, then insert the catheter deep into the tumor, inject embolism into the blood vessels to cause embolism.
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