Placental chorioangioma - an unusual cause of acute polyhydramnios with an isolated rise in maternal serum ALT: a clinical marker of disease and/or risk?

摘要

A 29-year-old primiparous woman of Pakistani origin booked for shared care. An ultrasound scan confirmed a viable pregnancy of 11 weeks' gestation. An anomaly scan at 20 weeks' gestation was unremarkable and the pregnancy continued without event until, at 32 + weeks' gestation, she presented with a 2-day history of abdominal pain and reduced fetal movements. Clinical examination revealed a tense irritable abdomen and an ultrasound scan confirmed gross polyhydramnios (amniotic fluid index (AFI) 427 mm; > 95th centile). Normal views of the fetal heart, stomach, bladder and kidneys were seen. Concerns with regard to possible pre-term labour led initially to hospital admission. Corticosteroids were administered to accelerate fetal lung maturation, although tocolysis was not felt necessary at this time (the cervix was long, posterior and closed).