Severe preeclampsia and embryonic hydatidiform mole with live fetus

Abstract

Introduction: preeclampsia is a state of human pregnancy that occurs after 18 weeks of gestation. Its presentation before that time, although rare, is associated with gestational trophoblastic disease or molar pregnancy. Gestational trophoblastic disease is characterized by a hydropic degeneration of the placental chorion villi, usually in the absence of the fetus.

Objective: to describe a case of severe preeclampsia before 20 weeks' gestation, associated with a molar pregnancy with a live fetus, an unusual case according to recent reviews in the literature.

Presentation of the case: a patient of 31 years of age and 15 weeks of gestation. She came to the Gyneco-Obstetrics Emergency Service of the Provincial General Teaching Hospital "Dr. Antonio Luaces Iraola" for presenting dyspnoea, dyspepsia, and pain in the base of the right lung. Physical and complementary exams were carried out. In the obstetrical ultrasound were observe a fetus –small for the time of gestation–, a large placenta with hydropic degeneration and appendages similar to tecaluteinics cysts, and little liquid. The diagnosis was partial hydatidiform mole with live fetus.

Discussion: although specific fetal anomalies are not frequent in partial mole, fetal growth retardation is almost always found. The classic echographic aspect of the partial mole corresponds to that of an enlarged placenta, of 4 cm or more in thickness, with multi-cystic, avascular and anechoic spaces.

Conclusions: before precocious preeclampsia should be establish its posible relationship with an embryonic partial hydatidiform mole