Abstract
Massive subchorionic thrombohematoma (Breus’ mole) is a rare condition characterized by a significant clot of maternal blood separating the chorionic plate from the villous chorion. The exact etiology and pathogenesis remain unclear. This condition can lead to complications such as restricted fetal growth, oligohydramnios, preeclampsia, preterm birth, and intrauterine fetal death. We report two cases of Breus’ mole in order to emphasize the importance of diagnostic suspicion for effective management. The analysis was retrospective, and both patients gave consent for the reporting of their cases. Case one had a gestational age of 24+4, an uncontrolled maternal chronic hypertension. Ultrasound revealed placentomegaly, severe early fetal growth restriction, oligo- anhydramnios sequence, and severe anemia due to placental insufficiency. During hospitalization, pressure adjustment and corticosteroid therapy were necessary, as a new ultrasound indicated pathological ductus venosus. A cesarean section was performed, but the infant did not survive. Case two had a gestational age of 26+5, with acquired thrombophilia. Ultrasound showed oligohydramnios, placentomegaly, and pathological ductus venosus, which lead to cesarean indication. In conclusion, due to its rarity and unknown pathogenesis, little can be done in terms of prophylaxis. However, we must suspect the condition to improve management of potential cases with complications.
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Copyright (c) 2024 Renata L. Pfann, Barvara M. Wagner, Denise H. Matsubara, Tamy LY. Sato, Marina N. Machado, Alexandre B. Leite, Flávio C. Leite