Exploring the Prospects of Antenatal Microcoil Embolization of Giant Placental Chorioangioma: Case Report and Review of Literature

Abstract

AbstractGiant placental chorioangiomas, which measure more than 4 cm, are associated with adverse maternal, fetal, and neonatal outcomes, with an estimated perinatal mortality of 30 to 40%. Early diagnosis, close prenatal surveillance, intrauterine intervention, and timely delivery would play a vital role in improving pregnancy outcomes. Using conventional treatment options like amniodrainage to reduce intrauterine pressure and intrauterine blood transfusion to correct fetal anemia fails to tackle the underlying pathophysiology. Interventions aimed at devascularizing the tumor, such as injection of alcohol or surgical glue, use of bipolar cautery, placement of vascular clips, interstitial laser, and radiofrequency ablation, have had mixed results due to their invasive nature and associated complications. In this case report, we discuss a minimally invasive, percutaneous, extraamniotic method of focal occlusion accomplished by microcoil embolization of the feeding vessel. The combination of slow blood flow and endothelial vessel damage due to the presence of coils stimulates thrombogenic mechanisms, contributing to the formation of a clot and leading to the cessation of blood flow to the chorioangioma, thereby treating the primary pathology.