Trisomy 16 is the most frequent autosomal anomaly seen in early spontaneous abortions, accounting for 15 per cent of all chromosomally abnormal early spontaneous abortions. This trisomy is thought to be lethal in the non‐mosaic state and incompatible with full fetal development. We report a case of placental trisomy 16 mosaicism detected after chorionic villus sampling (CVS). The patient was referred at 18 weeks of gestation on account of moderate intra‐uterine growth restriction (IUGR). Detailed sonography showed a thickened and enlarged placenta with multiple ‘cysts’, polyhydramnios, a single umbilical artery and a small ventricular septal defect (VSD). CVS, amniocentesis (AC) and fetal blood sampling (FBS) were performed. After direct preparation of chorionic villi only 47, XX,+16 cells were seen. However, chromosomal analysis of cultivated amniotic fluid cells and fetal lymphocytes only showed a normal karyotype 46, XX. After direct preparation of a second CVS at 19+4 weeks of gestation the karyotype 47, XX+16 was confirmed in the contralateral part of the placenta and near the insertion of the umbilical cord. A normal female karyotype 46, XX was demonstrated by extensive karyotyping of various sites of the placenta, the neonatal skin fibroblasts and lymphocytes postnatally. In accordance with this observation the multiple ‘cysts’ of the placenta disappeared in the third trimester. We speculate that the sonographic findings of multiple round placental ‘cysts’ without a hyperreflective border may be caused by the trisomic cell lineages and therefore may be a sonographic marker of trisomy 16. Copyright © 1998 John Wiley & Sons, Ltd.

Objective We report a case of combined ovarian and intrauterine pregnancy successfully treated by pelviscopy after spontaneous abortion of the intrauterine pregnancy. We discuss the frequency, pathogenic aspects, diagnostic management and therapeutic possibilities of such a rare type of ectopic pregnancy. Subject A 25‐year‐old primigravida, who had conceived after ovarian stimulation with clomiphene, came to our hospital 3 weeks after curettage of the uterine cavity for an incomplete abortion. An ovarian pregnancy was suspected on transvaginal sonography and this diagnosis was confirmed histologically after pelviscopic treatment. Conclusion Minimally invasive diagnostic and therapeutic management of ectopic pregnancy in early pregnancy should be employed for confirmation of the diagnosis of such a rare combination of intrauterine and ovarian pregnancy. We propose that our surgical management has a high degree of safety for the patient and involves lower hospitalization costs.

No abstract