Massive Fetomaternal Hemorrhage Caused by an Intraplacental Choriocarcinoma: A Case Report

Background. Intraplacental choriocarcinoma is a rare but highly malignant trophoblastic neoplasm. When found near term the risk of maternal metastasis is high because of the late diagnosis. Case. We describe a case of an intraplacental choriocarcinoma diagnosed postpartum after a near-term delivery of a severely anemic infant. A fetomaternal hemorrhage resulted in a hemoglobin concentration in the infant of only 2,1 g/dL. Neither mother nor child showed signs of metastatic disease. The macroscopic examination showed a hydropic placenta weighing more than 1 kilogram. Microscopy showed an intraplacental choriocarcinoma 3 cm in diameter. The tumor had infiltrated the maternal basal plate. Conclusion. Fetomaternal bleeding is a rare form of presentation of choriocarcinoma but its presence should always warrant detailed examination of placenta, mother, and infant

Kinetics of silica nanoparticles in the human placenta

The potential medical applications of nanoparticles warrant their investigation in terms of biodistribution and safety during pregnancy. The transport of silica nanoparticles (NPs) across the placenta was investigated using two models of maternal-fetal transfer in human placenta, namely, the BeWo b30 choriocarcinoma cell line and the ex vivo perfused human placenta. Nanotoxicity in BeWo cells was examined by the MTT assay and demonstrated decreased cell viability at concentrations greater than 100 μg/mL. In the placental perfusion experiments, antipyrine crossed the placenta rapidly, with a fetal/maternal ratio of 0.97 ± 0.10 after 2 hours. In contrast, the percentage of silica NPs reaching the fetal perfusate after 6 hours was limited to 4.2 ± 4.9% and 4.6 ± 2.4% for 25-nm and 50-nm NPs, respectively. The transport of silica NPs across the BeWo cells was also limited, with an apparent permeability of only 1.54 × 10(−6) ± 1.56 × 10(−6) cm/sec. Using confocal microscopy, there was visual confirmation of particle accumulation in both BeWo cells and in perfused placental tissue. Despite the low transfer of silica NPs to the fetal compartment, questions regarding biocompatibility could limit the application of unmodified silica NPs in biomedical imaging or therapy