Fetal diagnosis and therapy · 2026
Fetal Intervention for Giant Chorangioma with Prenatal Ductus Arteriosus Closure: A Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lemoine Felicia V, Neff Natalie, Backley Sami, Bhimani Salima A, Bianco Angela, Stone Joanne, Miller Russell, Johnson Anthony, Espinoza Jimmy, Zvavanjanja Rodrick C, Papanna Ramesha
Аннотация
INTRODUCTION: We present a case of spontaneous premature ductus arteriosus (DA) closure following modified interstitial laser ablation (ILA) of a giant chorangioma (GC) in a fetus with evidence of hydrops.
CASE PRESENTATION: A 26-week ultrasound revealed a 10-cm GC in the posteriorly located placenta with signs of fetal hydrops, polyhydramnios, and elevated middle cerebral artery peak systolic velocity (MCA PSV) of 1.9 MoM. Preoperative fetal echocardiogram showed elevated combined cardiac output (753 mL/kg/min) without structural abnormalities. Modified ILA targeting the branches of the feeder artery with an extended-pulse technique (30 s at 40 Watts) followed by intrauterine fetal transfusion was performed without complications. On postoperative day (POD) 1, new onset of ductus venosus flow reversal was noted, which was attributed to post-procedural hemodynamics. Fetal echocardiography on POD 5 suggested constriction of DA; follow-up confirmed complete DA closure and secondary right heart dysfunction. The pregnancy was managed expectantly with at least weekly echocardiograms. Digoxin and hyperoxygenation for fetal heart failure did not change DA caliber. Acetaminophen and fluoxetine were discontinued without improvement. After an uncomplicated term cesarean delivery (indication: breech), the female neonate was discharged home on day of life 3. Currently, the child is 6 months old and healthy.
CONCLUSION: Modified ILA for GC followed by expectant management of associated DA closure yielded a term delivery with a favorable outcome.
CASE PRESENTATION: A 26-week ultrasound revealed a 10-cm GC in the posteriorly located placenta with signs of fetal hydrops, polyhydramnios, and elevated middle cerebral artery peak systolic velocity (MCA PSV) of 1.9 MoM. Preoperative fetal echocardiogram showed elevated combined cardiac output (753 mL/kg/min) without structural abnormalities. Modified ILA targeting the branches of the feeder artery with an extended-pulse technique (30 s at 40 Watts) followed by intrauterine fetal transfusion was performed without complications. On postoperative day (POD) 1, new onset of ductus venosus flow reversal was noted, which was attributed to post-procedural hemodynamics. Fetal echocardiography on POD 5 suggested constriction of DA; follow-up confirmed complete DA closure and secondary right heart dysfunction. The pregnancy was managed expectantly with at least weekly echocardiograms. Digoxin and hyperoxygenation for fetal heart failure did not change DA caliber. Acetaminophen and fluoxetine were discontinued without improvement. After an uncomplicated term cesarean delivery (indication: breech), the female neonate was discharged home on day of life 3. Currently, the child is 6 months old and healthy.
CONCLUSION: Modified ILA for GC followed by expectant management of associated DA closure yielded a term delivery with a favorable outcome.