Farazestanian Marjaneh, Maleki Asieh, Bolandi Somayeh, Yousefi Zohreh, Hasanzadeh Malihe, Shirinzadeh Laya, Kamandi Sara
Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
J Family Reprod Health. 2020 Sep;14(3):205-208. doi: 10.18502/jfrh.v14i3.4675.
The presence of a normal fetus with normal karyotype accompanied by molar changes in the placenta is a rare condition, which carries a significant risk to the mother and fetus. There is a controversy regarding the proper management of this condition. Here, we present the case of a singleton pregnancy that showed molar changes in the pathological study of the placenta, but ended up with a normal viable neonate. A 23-year-old primigravida woman, with a 3-year history of infertility, presented with vaginal bleeding and spotting. Her ß-human chorionic gonadotropin (HCG) at 13 week was 36500 mIU/ml. Serial sonography assessments were suggestive for molar changes and a normal fetus with growth retardation but normal Doppler assessment. The patient underwent elective Cesarean section at 37 weeks gestation and a healthy female neonate with an Apgar score of 9-10, weighing 2270 g was born. Pathological assessment of the placenta confirmed the diagnosis of incomplete hydatidiform mole. After two months, the mother had no complications, her ß-HCG level was untraceable, and the infant was in good condition. Despite being a rare condition, partial moles can be accompanied by delivery of a normal fetus. The management of this condition still remains challenging and should be done under close monitoring with extreme caution.
正常核型胎儿伴有胎盘葡萄胎样改变是一种罕见情况，对母亲和胎儿均有重大风险。关于该情况的恰当处理存在争议。在此，我们报告一例单胎妊娠病例，其胎盘病理检查显示葡萄胎样改变，但最终娩出一名正常存活新生儿。一名23岁初孕妇，有3年不孕史，出现阴道出血和点滴出血。她在孕13周时的β-人绒毛膜促性腺激素（HCG）为36500 mIU/ml。系列超声检查提示葡萄胎样改变以及一个生长受限但多普勒评估正常的正常胎儿。该患者在妊娠37周时接受了择期剖宫产，娩出一名健康女婴，阿氏评分9 - 10分，体重2270 g。胎盘病理评估确诊为部分性葡萄胎。两个月后，母亲无并发症，其β-HCG水平无法检测到，婴儿状况良好。尽管是罕见情况，但部分性葡萄胎可伴有正常胎儿的娩出。该情况的处理仍然具有挑战性，应在密切监测下极其谨慎地进行。
