Partial Hydatidiform Mole with Alive Term IUGR Foetus

Abstract

Gestational Trophoblastic diseases consist of a broadspectrum of conditions ranging from an uncomplicated partial hydatidiform molar pregnancy to stage -IV choriocarcinoma with cerebral metastasis. Incidence of hydatidiform mole with a co-existing live fetus varies between 0.005 to 0.01 % of all pregnancies. We report a case of partial molar pregnancy with alive term IUGR (intrauterine growth retardation) foetus. Diagnosis was made by sonographic findings of molar changes at her 28 weeks of gestation.Anomaly scan showed no fetal abnormality. At 40 weeks of pregnancy patient went to spontaneous labour and delivered a severely IUGR baby weighing 1.5 kg and it was morphologically normal. There was a single placenta; one third of it was replaced by molar tissue. As the singletone alive pregnancy with partial molar changes is extremely rare occurrence we reported the case here.

Mola parcial con feto vivo, complicado con restricción de crecimiento intrauterino y preeclamsia severa. Reporte de caso y revisión de la literatura

“…Sitio del estudio: un total de 5 estudios fueron realizados en Estados Unidos (13,(20)(21)(22)(23), tres en India (24)(25)(26), dos en México (27,28), dos en China (29,30) (29,32,38,41), de 28 a 37 semanas 6 casos (24,27,36,37,39) y 37 semanas o más en 4 casos (13,26,31). El método de diagnóstico fue ultrasonido prenatal en 21 casos (20,21,(23)(24)(25)27,28,30,(32)(33)(34)(35)37,40,(42)(43), y en el alumbramiento o por patología, 10 casos (13,26,29,31,36,38,39,41,43). Se ofreció terminación del embarazo en 4 casos (20,23).…”

“…La edad gestacional al momento de la terminación del embarazo osciló entre las 15 y las 40 semanas: de 22 semanas o menos, 9 casos (20,22,23,28,40); de 23 a 27 semanas, 4 casos (29,32,34,38); de 28 a 37 semanas, 13 casos (21,24-25-26-28,30,33,36,39,41,42-43) y de 38 a 42 semanas, 5 casos (13,26,31,35,37). Respecto al tipo de parto: parto por cesárea, 12 casos (8,21,26,27,(30)(31)(32)(33)(34)39,42,43), parto vaginal, 10 casos (13,25,28,29,(35)(36)(37)41,42).…”

Singleton Partial Molar Pregnancy Delivered in Third Trimester: A Case Report

“…Although triploidy is the most frequent association, a fetus with normal karyotype (diploidy) can survive in cases of partial molar pregnancy. Singleton Partial mole with a live fetus may occasionally survive into full term [1,2,7] and even to the school age [8,9]. Fetuses with triploidy cannot survive after birth because of multiple malformations and severe intrauterine fetal growth retardation (IUGR) secondary to affected placental circulation.…”

“…Gestational Trophoblastic diseases (GTD) consist of a broad spectrum of conditions ranging from an uncomplicated partial hydatidiform molar pregnancy to choriocarcinoma with cerebral metastasis. Molar pregnancy is significantly more common in extremes of age [1,2]. Partial molar (PM) pregnancy is a rare entity in which there is a triple abnormal fetus associated with a large placenta with cystic changes [3].…”

“…Pregnancies with normal live fetus coexistent in with partial molar placenta are extremely rare because of numerous maternal and fetal complications. The incidence of hydatidiform mole with a coexisting live fetus varies between 0.005 to 0.01 % of all pregnancies [2].…”