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Prenatal diagnosis of molar abnormalities coexisting with a fetus. A recent literature review and a case report

par Jauniaux, Eric ;De Lannoy, E.;Moscoso, Gonzalo;Campbell, Genevieve
Référence Journal de gynécologie obstétrique et biologie de la reproduction, 19, 8, page (941-946)
Publication Publié, 1990

Article révisé par les pairs

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Résumé :

A case of twin pregnancy combining a complete mole and a normal pregnancy is reported. A spontaneously aborted partial triploid mole was found in the past medical history of the patient. Prenatal investigations showed an heterogenous mass suggestive of a trophoblastic disorder coexisting with a normal placenta and a morphologically normal fetus on sonography associated with increased levels of hCG and normal levels of AFP in the maternal serum. High-resolution color Doppler imaging showed no blood flow within the suspect mass, excluding a myoma in necrobiosis or a large placental chorioangioma. The patient did not present the severe complications classically described in classical mole and a passive conservative attitude was adopted. The pregnancy ended prematurely and the patient delivered at 27 weeks of gestation of a phenotypically normal infant. The mother and the baby had an unremarkable post-partum course. The review of the recent literature showed that partial hydatidiform mole could be separated in four categories: triploid partial moles; twin pregnancies combining a complete mole and a normal pregnancy; diploid partial mole; and pseudo-moles. Detailed sonographic examination and evaluation of maternal serum hCG and AFP should allow prenatal differential diagnosis of these pathological entities.