Bulgarian doctors applied innovative therapy for a rare placental tumor

A maternal-fetal medicine team from the Dr. Shterev Medical Complex has successfully applied an innovative therapeutic approach in an extremely rare and high-risk case of a large placental tumor during pregnancy, the medical facility reported.

The case involves a placental chorioangioma—a rare vascular formation that, in large sizes, occurs in only 0.02–0.03% of pregnancies and can lead to severe complications for the fetus, including pregnancy loss.

The unique aspect of this case is that the doctors used propranolol therapy—a medication primarily used for high blood pressure, but almost never utilized for this type of diagnosis until now. According to the team, only one other similar case has been described in global medical literature.

The patient was referred to the specialists in the 29th gestational week after a suspected serious placental anomaly was identified. During the examination, a large and highly vascularized tumor located near the placental insertion of the umbilical cord was diagnosed.

Due to the high risk of intrauterine intervention, the doctors decided to apply an alternative therapy using propranolol.

“At that point, the options for intervention were very limited, and the risk to the entire pregnancy was too great,” explained Dr. Vasilev.

After starting the treatment, the pregnancy was extended by another six weeks—until the 35th gestational week. The baby was born weighing 2,500 g, and six months later, is developing normally without complications.

The case has already been sent to an international research group in the Netherlands, which collects data on the treatment of placental chorioangiomas with propranolol to accumulate more clinical experience and develop an international consensus.

The medical facility noted that this is the second such successful case for the team. In 2024, the specialists diagnosed and treated another high-risk pregnancy with a large placental tumor, where an intrauterine intervention was performed to interrupt the blood flow to the formation. That pregnancy reached the 39th week and ended with the birth of a healthy baby.