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Chorioangiomas of the Placenta

Sonographic and Doppler Flow Characteristics

Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; affiliated with the Sackler School of Medicine, Tel-Aviv University, TelAviv, Israel.

Address correspondence and reprint requests to Yaron Zalel, MD, Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer 52621, Israel.

Objective. To evaluate our experience with sonography and color Doppler blood flow in the diagnosis and management of chorioangiomas of the placenta. Methods. All cases with placental chorioangiomas diagnosed in our sonography unit between 1992 and 2001 were included in the study. Sonographic and color Doppler flow characteristics were evaluated in all cases. Our cases were compared with all cases of placental chorioangiomas diagnosed antenatally by sonography published in the English literature between 1978 and 2001. Results. Six cases of placental chorioangioma were identified antenatally, with a mean size of 6.5 cm (range, 4–13 cm). With the use of color Doppler flow, all cases of chorioangioma were shown to have either abundant blood flow or a large feeding vessel within the tumor. During follow-up, 2 cases had reduction of the intratumoral blood flow, and the outcomes were favorable. Three of our cases had delivery before 33 weeks’ gestation (1 with intrauterine fetal death and 1 with termination of pregnancy). Review of the literature revealed 72 cases of antenatally diagnosed placental chorioangioma. Two thirds of the cases had dismal outcomes. Conclusions. The sonographic diagnosis of chorioangiomas of the placenta is feasible and necessitates close surveillance of these pregnancies because of the dismal prognosis in more than half. The addition of color Doppler flow is important in the diagnosis and antenatal follow-up of these pregnancies.

Key Words: chorioangioma • Doppler flow • placenta • ultrasonography

Abbreviations: IUFD, intrauterine fetal death • IUGR, intrauterine growth restriction

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