胎盘绒毛膜血管瘤10例临床分析

Clinical Analysis of Ten Cases of Placental Chorioangioma

目的探讨胎盘绒毛膜血管瘤的诊断方法、母儿并发症及处理方法。方法回顾性分析2010年1月至2019年12月郑州大学第一附属医院产科收治的10例胎盘绒毛膜血管瘤患者的临床资料。结果10例胎盘绒毛膜血管瘤中,单胎9例、双胎1例。胎盘绒毛膜血管瘤大小为45 mm×45 mm×20 mm~130 mm×110 mm×70 mm,6例为单发血管瘤,4例为多发血管瘤。母儿并发症有羊水过多(3例)、羊水过少(1例)、妊娠糖尿病(2例)、胎膜早破(1例)、妊娠期贫血(8例)、胎盘早剥(2例)、胎儿宫内窘迫(3例)、胎儿生长发育受限(2例)、重度子痫前期(1例)、胎儿水肿(1例)、胎儿心胸比增大(1例)及新生儿贫血(2例)。10例患者中1例接受利凡诺引产,余均接受剖宫产术,其中足月4例、早产5例,9例新生儿预后均良好。结论胎盘绒毛膜血管瘤可引起多种母儿并发症,孕期应定期接受超声检查,及时诊断和处理,必要时进行干预,选择适当的分娩时机以及分娩方式,进而改善妊娠结局。

Objective To investigate the diagnosis,maternal and child complications and management of placental chorioangioma.Methods The clinical data of 10 cases of placental chorioangioma admitted to Department of Obstetrics of the First Affiliated Hospital of Zhengzhou University from January 2010 to December 2019 were retrospectively analyzed.Results Among the 10 cases of placental chorioangioma,there were 9 single cases and 1 twin case.The size of placental chorioangioma was 45 mm×45 mm×20 mm to 130 mm×110 mm×70 mm,6 cases of single hemangioma,4 cases of multiple.Maternal and child complications were hydramnios(3 cases),oligohydramnios(1 case),gestational diabetes(2 cases),premature rupture of membranes(1 case),gestational anemia(8 cases),placental abruption(2 cases),fetal distress(3 cases),fetal growth and development limited(2 cases),severe preeclampsia(1 case),fetal edema(1 case),fetal heart than increase(1 case)and neonatal anemia(2 cases).All the 10 patients were confirmed with placental chorioangioma by postpartum placental pathology.One was induced by Rivanol,and the remaining 9 underwent cesarean section,including 4 cases of term and 5 cases of premature delivery.All the 9 neonates had a good outcome.Conclusion Placental chorioangioma can cause a variety of maternal and child complications,pregnancy should be regular ultrasound examination,timely diagnosis and treatment,intervention when necessary,choose the appropriate timing and delivery mode,and then improve the outcome of pregnancy.