Outcome and follow-up
At 34+5 weeks gestation, the patient presented to our
emergency department with complaints of labor pain. The subsequent
workups revealed the diagnosis of preeclampsia, prompting the decision
for emergency CS delivery. A female neonate weighing 2315 grams was
delivered, measuring 45 cm in length and with a head circumference of 32
cm. The neonate exhibited Appearance, Pulse, Grimace, Activity, and
Respiration (APGAR) scores of 1 at 1 and 5 minutes and was diagnosed
with hydrops fetalis. Unfortunately, despite resuscitative efforts, the
neonate passed away within the first hour of life.
The placenta weighed 1300 g and measured 26 cm in greatest diameter,
with a maximum thickness of 9 cm at the central portion. The umbilical
cord measured 24 cm in length. Upon sectioning, multiple well-defined
creamy-red rubbery tissues were observed, with the largest masses
measuring 6x5x4 cm, 4.2x4x3 cm, and 4x3.5x3.5 cm along the chorionic
surface of the placenta. (Figure 3) The retroplacental
hemorrhage covered approximately 10% of the placental surface area. The
histopathological examination revealed a distinctive pattern of
trophoblastic layers enveloping numerous capillary-sized vascular
channels. Additionally, focal laminar decidual necrosis and the presence
of meconium-laden macrophages were noted, conclusively confirming the
diagnosis of placental chorangioma, capillary type.
(Figure 4) The patient’s recovery remained uneventful,
with no reported postoperative complications.