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.