Differential diagnosis, investigations and treatment
The subsequent fetal ultrasound revealed multiple well-defined
hypoechoic lesions within the placenta with increased vascularity,
indicating placental chorioangioma. (Figure 1)
Additionally, various fetal anomalies were identified, including
features indicative of large for gestational age, cleft lip and palate,
hypoplastic lung, and a hyperechoic lung mass adjacent to the left
atrium with systemic circulation. Notably, no signs of hydrops fetalis
were observed. Moreover, fetal Doppler assessment revealed an increased
peak systolic velocity of the middle cerebral artery (MCA-PSV) measuring
92, with 2.14 multiples of the median (MoM) for the gestational age, and
an umbilical artery pulsatility index (PI) of 1.01. These findings were
indicative of fetal anemia, accompanied by pulsatile turbulent flow.