La adherencia anormal de la placenta al músculo uterino se conoce como acretismo placentario y es una patología que incrementa notablemente la morbimortalidad materna. La inserción de las vellosidades coriales directamente en el miometrio se presenta con mayor frecuencia en mujeres que han sufrido alguna alteración anatómica quirúrgica en el miometrio, como en el caso de las cesáreas o miomectomías. Si bien se ha descrito tratamientos conservadores de esta patología, el manejo recomendado es la histerectomía. Se presenta un caso de acretismo placentario en una mujer de 22 años sin factor de riesgo o antecedente quirúrgico que predispusiera a dicha patología.
Aims: To describe a case of hydatidiform mole coexisting with healthy and alive fetus at birth in Mexico. Presentation of Case: A 35 years old pregnant patient at 18+5 weeks of gestational age and a viable fetus by ultrasound, with atypical pneumonia, plus scant bilateral pleural effusion and partial mole implants on admission to hospital. At week 39 of gestation, the pregnancy was interrupted abdominally; a gestation product was obtained, alive, female, and without malformations. The patient did not present complications. The histopathological report of the placenta was compatible with a partial mole. Discussion: Gestational trophoblastic disease includes partial hydatidiform mole, its occurrence in coexistence with alive and healthy fetus at birth is 0.005-0.01% respect to the total number of pregnancies. The viability of the term of pregnancy will depend on maternal comorbidities, fetalsss well-being and accessible medical surveillance. The ultrasound is the main diagnostic tool. Clinical monitoring is of vital importance after the end of pregnancy, mainly in mother, due to the risk of developing metastatic disease and recurrence of molar pregnancy. Conclusion: The case report described is relevant, due to its infrequency. In addition, the imaging findings, emphasizes the importance of a complete and adequate evaluation of the placenta and the fetus, in viable gestation conditions in coexistence with partial mole.
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