Case Report Role of Multidisciplinary Team Management in Women with Placental Chorioangioma and Valvular Heart Disease

Abstract

Chorioangioma, a non-trophoblastic benign tumor without any malignant tendency originates from placenta and can affect fetal outcome. The diagnosis is usually made in the second trimester of pregnancy. The place of tumor is usually on the fetal side in close connection to the umbilical cord site and it protrudes into the amniotic cavity. These can either be small (less than five centimeters) or large (more than five centimeters) tumors with favorable and unfavorable fetal outcomes respectively. The tumor larger in size can cause preterm labour, placenta previa, pre-eclampsia, polyhydramnios, hemorrhage in mothers while fetus complications can include growth restriction, thrombocytopenia, cardiomegaly, anemia and fetal hydrops etc. The diagnosis can be made earlier by using color Doppler and earlier intervention can be done through multidisciplinary team management for reducing maternal as well as fetal complications. Here, presenting a case report of a pregnant patient with Rheumatic heart disease having Chorioangioma of size 5.0x3.0 cm diagnosed at nineteen weeks at the time of anomaly scan. She was kept for regular follow up till 33 weeks when the umbilical artery Doppler scan revealed absent end diastolic flow and emergency LSCS was performed under steroid cover. Female baby was born with birth weight of 1.8 kg (low birth weight) and admitted to neonatal unit while mother was taken to CCU and remained there for fifteen days under extensive treatment by the multidisciplinary team including cardiologist, intensivist and internal medicine specialist. The multidisciplinary team management increased the maternal as well as fetal outcome.