ROLE OF MULTIDISCIPLINARY TEAM MANAGEMENT IN WOMEN WITH PLACENTAL CHORIOANGIOMA AND VALVULAR HEART DISEASE

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Shafaq Nadeem
Shamoona
Attiya Rehman

Abstract

Chorioangioma, a non-trophoblastic benign tumor without any malignant tendency, originates from the placenta and can affect fetal outcome. The diagnosis is usually made in the second trimester of pregnancy. The tumor is usually on the fetal side in close connection to the umbilical cord site and protrudes into the amniotic cavity. These can either be small (less than five centimeters) or large (more than five centimeters) tumors with favorable and unfavorable fetal outcomes, respectively. The larger tumor can cause preterm labour, placenta previa, pre-eclampsia, polyhydramnios, hemorrhage in mothers. At the same time, fetus complications can include growth restriction, thrombocytopenia, cardiomegaly, anemia, fetal hydrops, etc. The diagnosis can be made earlier by using color Doppler and earlier intervention can be done through multidisciplinary team management to reduce maternal and fetal complications. Here, presenting a case report of a pregnant patient with Rheumatic heart disease having Chorioangioma of size 5.0x3.0 cm diagnosed at nineteen weeks at the time of anomaly scan. She was kept for regular follow-up until 33 weeks when the umbilical artery Doppler scan revealed absent end diastolic flow and emergency LSCS was performed under steroid cover. A female baby was born with a birth weight of 1.8 kg (low birth weight) and admitted to the neonatal unit. At the same time, mother was taken to CCU and remained there for fifteen days under extensive treatment by the multidisciplinary team including cardiologist, intensivist and internal medicine specialist. The multidisciplinary team management increased the maternal as well as fetal outcome

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Case Report