On August 29, Dr. Tran Ngoc Hai, Director of Tu Du Hospital (HCMC), said that the first joint obstetrics-pediatrics intervention successfully treated a placental hemangioma, saving the life of a fetus in the womb.
Specialist Doctor 2 Trinh Nhut Thu Huong, Head of the Prenatal Care Department, Tu Du Hospital, added: pregnant woman VTTN (35 years old, living in Tay Ninh) was discovered to have a placental hemangioma at 17 weeks of pregnancy and the tumor continued to grow.
At 26 weeks, the pregnant woman was consulted by Tu Du Hospital with Children's Hospital 1 and diagnosed with a placental hemangioma causing anemia, fetal edema, fetal distress... The placental hemangioma was as big as a bowl.
Placental hemangioma vascular occlusion
"If not treated, the hemangioma will cause many complications. Accordingly, 30% will cause premature labor and the mortality rate will be up to more than 50%. The hospital also cannot deliver the baby at 26 weeks," said Dr. Thu Huong.
The pregnant woman was assigned to have intervention to block the blood vessels that feed the tumor. This procedure was performed at Tu Du Hospital, in coordination with the teams from Tu Du Hospital and Children's Hospital 1 at 26.5 weeks of pregnancy. The fetus then received a blood transfusion.
According to Dr. Thu Huong, up to now, for cases like the above, only supportive treatment was given, meaning if the baby had anemia, a blood transfusion was given, if there was heart edema, cardiac medication was used, but the root cause of the blockage of the blood vessels feeding the placenta and the cause of anemia in the baby was not treated, meaning targeted treatment was not given.
10 days ago, the mother was hospitalized for close monitoring because of a large, thick, sticky placental hematoma and the risk of postpartum hemorrhage. Furthermore, the mother had an old surgical scar...
On the morning of August 29, doctors at Tu Du Hospital successfully performed a cesarean section for a pregnant woman.
On the morning of August 29, when the fetus was 37.5 weeks old, Tu Du Hospital performed a cesarean section for the mother. Anticipating the risk of hemorrhage, the medical team controlled the bleeding within 2 minutes after the surgery, and the baby was born well-developed, weighing 2.9 kg.
According to Dr. Tran Ngoc Hai, this is a successful case of selective endovascular embolization to treat a placental hemangioma in Vietnam, performed at 26.5 weeks of pregnancy. Because it was the first intervention, everyone was nervous because of the risk of bleeding, premature placental abruption, fetal death, etc.
Placental hemangioma is a non-trophoblastic vascular tumor of the placenta with an incidence of only about 1%. The incidence of large placental hemangioma (more than 4.5 cm) is rare, about 1/3,500 - 1/9,000/case. If the placental hemangioma is small, there may be no abnormal symptoms. However, when the placental hemangioma is large (from 4 - 5 cm), it can cause complications that can affect placental circulation.
Complications of large placental hemangioma include: fetal hydrops (14% - 28% of cases); fetal anemia; premature birth; fetal heart failure; fetal growth retardation; stillbirth.
Placental vascular occlusion is a modern endovascular intervention technique. Currently in the world, there are methods to treat large placental hemangiomas, such as: endovascular intervention to block placental blood vessels with chemicals, alcohol, vascular laser...
In particular, endovascular intervention to selectively embolize placental hemangiomas is a high-tech intervention guided by ultrasound, more precisely selecting blood vessels than laser technique, not as toxic as injecting alcohol into the vessel and not causing bleeding complications after needle removal.
This intervention technique requires accurately identifying the blood vessels that feed the tumor of the placenta, then inserting a catheter deep into the tumor and injecting an embolic agent into the vessel to cause embolism.
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