High Dose Corticosteroids in Chronic Histiocytic Intervillositis Allowing Prolongation of Pregnancy: A Case Report.

Chronic histiocytic intervillositis (CHI) is a rare placental disorder linked to poor pregnancy outcomes, including fetal growth restriction and perinatal loss. We report a case of recurrent CHI in a 36-year-old woman with five previous pregnancy losses. In her sixth pregnancy, placental histology confirmed CHI after preterm delivery. In a subsequent seventh pregnancy, despite early treatment with aspirin, low-molecular weight heparin, and hydroxychloroquine, she developed uteroplacental dysfunction at 17 weeks with hypertension, proteinuria, and transaminitis. Rescue therapy with high-dose prednisolone led to maternal clinical improvement, stabilization of fetal Dopplers, and pregnancy prolongation to 30 weeks. Placental histology showed a reduced inflammatory infiltrate compared to the prior pregnancy, suggesting a therapeutic effect from corticosteroids. This case reports the novel use of high-dose corticosteroid rescue therapy in managing CHI and highlights the importance of early diagnosis, multidisciplinary care, and the need for further research.