Management of a Partial Molar Pregnancy

Drummond, Susan; Fritz, E. B.

doi:10.1097/jpn.0b013e3181a16fb5

Cited by 3 publications

(5 citation statements)

References 24 publications

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“…The patient who does not undergo immediate induced abortion should be managed by Maternal Fetal Medicine and counselled regarding the risks of ongoing pregnancy. Unlike this case, hypertension and preeclampsia are described in most reports of partial molar pregnancy in the second trimester [2][3][4][5] . Blood pressure should be monitored closely.…”

Section: Discussionmentioning

confidence: 57%

“…Unlike this case, hypertension and preeclampsia are described in most reports of partial molar pregnancy in the second trimester. [2][3][4][5] Blood pressure should be monitored closely. It is possible that the metoprolol taken by our patient for SVT masked rising blood pressure before gestational hypertension could be diagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is limited evidence in the literature regarding the management of ongoing partial molar pregnancies. To our knowledge, there is one case report describing expectant management until preeclampsia prompted delivery by Cesarean section at 31 weeks' gestation 5 . There is no information regarding vaginal delivery in this context.…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, there is one case report describing expectant management until preeclampsia prompted delivery by cesarean section at 31 weeks' gestation. 5 There is no information regarding vaginal delivery in this context.…”

mentioning

confidence: 99%

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Expectant Management of a Triploid Partial Molar Pregnancy at 26 Weeks' Gestation: A Case Report

Wong,

Ali,

Stalder

et al. 2024

AJP Rep

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Introduction Triploid partial molar pregnancies are not viable, and confer maternal risks including preeclampsia, hemorrhage, gestational trophoblastic neoplasia, and trophoblastic embolization. We report a case managed expectantly until 26 weeks’ gestation in a patient requesting continuation of pregnancy. Case This G2P1 presented with fetal anomalies indicative of triploid partial molar pregnancy. The pregnancy was complicated by anemia, hyperthyroidism, supraventricular tachycardia, and threatened preterm labour. Her care involved Maternal Fetal Medicine collaborating with Internal Medicine, Palliative Care, Anesthesia and Critical Care. Labor was augmented at 26 weeks’ gestation, resulting in vaginal delivery. Postpartum course was notably complicated by acute respiratory distress in the immediate post-partum period, which self-resolved. Postpartum hemorrhage and retained products of conception were additional complications. Conclusion This unique case highlights the role of multidisciplinary collaboration and shared decision making in challenging circumstances.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Expectant Management of a Triploid Partial Molar Pregnancy at 26 Weeks' Gestation: A Case Report

Wong,

Ali,

Stalder

et al. 2024

AJP Rep

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“…Ultrasound is the primary diagnostic modality of partial molar pregnancy. It reveals placental changes, placenta insufficiency, fetal malformation, abnormal growth, and oligohydramnios [10][11][12]. Definitive diagnosis is done by cytogenetic analysis via amniocentesis or chorionic villus sampling [12].…”

Section: Discussionmentioning

confidence: 99%

Partial Molar Pregnancy With Normal Karyotype

Ghadeer¹,

Kishi²,

Algurini³

et al. 2022

Cureus

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Partial molar pregnancy results from fertilization of a haploid ovum by two sperms or duplication of one sperm, resulting in a triploid karyotype. The coexistence of partial mole with normal fetus karyotype is rare and occurs in 0.005-0.01% of all pregnancies. It is considered a challenging diagnosis. Here, we report a case of a 38-year-old primigravida diagnosed indecently at 16 weeks of gestation. She was on regular antenatal care and had partial molar pregnancy with a female fetus with diploid karyotype and no apparent malformation. This pregnancy ended with intrauterine fetal death. Histological examination of the placenta showed partial hydatidiform mole changes.

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Variants in Maternal Effect Genes and Relaxed Imprinting Control in a Special Placental Mesenchymal Dysplasia Case with Mild Trophoblast Hyperplasia

Huang

Chang

et al. 2021

Biomedicines

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Placental mesenchymal dysplasia (PMD) and partial hydatidiform mole (PHM) placentas share similar characteristics, such as placental overgrowth and grape-like placental tissues. Distinguishing PMD from PHM is critical because the former can result in normal birth, while the latter diagnosis will lead to artificial abortion. Aneuploidy and altered dosage of imprinted gene expression are implicated in the pathogenesis of PHM and also some of the PMD cases. Diandric triploidy is the main cause of PHM, whereas mosaic diploid androgenetic cells in the placental tissue have been associated with the formation of PMD. Here, we report a very special PMD case also presenting with trophoblast hyperplasia phenotype, which is a hallmark of PHM. This PMD placenta has a normal biparental diploid karyotype and is functionally sufficient to support normal fetal growth. We took advantage of this unique case to further dissected the potential common etiology between these two diseases. We show that the differentially methylated region (DMR) at NESP55, a secondary DMR residing in the GNAS locus, is significantly hypermethylated in the PMD placenta. Furthermore, we found heterozygous mutations in NLRP2 and homozygous variants in NLRP7 in the mother’s genome. NLRP2 and NLRP7 are known maternal effect genes, and their mutation in pregnant females affects fetal development. The variants/mutations in both genes have been associated with imprinting defects in mole formation and potentially contributed to the mild abnormal imprinting observed in this case. Finally, we identified heterozygous mutations in the X-linked ATRX gene, a known maternal–zygotic imprinting regulator in the patient. Overall, our study demonstrates that PMD and PHM may share overlapping etiologies with the defective/relaxed dosage control of imprinted genes, representing two extreme ends of a spectrum.

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Management of a Partial Molar Pregnancy

Cited by 3 publications

References 24 publications

Expectant Management of a Triploid Partial Molar Pregnancy at 26 Weeks' Gestation: A Case Report

Expectant Management of a Triploid Partial Molar Pregnancy at 26 Weeks' Gestation: A Case Report

Partial Molar Pregnancy With Normal Karyotype

Variants in Maternal Effect Genes and Relaxed Imprinting Control in a Special Placental Mesenchymal Dysplasia Case with Mild Trophoblast Hyperplasia

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