Acute onset of severe hemolysis, elevated liver enzymes, and low platelet count syndrome in a patient with a partial hydatidiform mole at 17 weeks gestation

Am J Perinatol. 2006 Apr;23(3):163-6. doi: 10.1055/s-2006-934093. Epub 2006 Mar 29.

Abstract

Preeclampsia is uncommon prior to 24 weeks gestation and has been associated with partial and complete hydatidiform moles. We present an unusual case in which a patient was diagnosed with preeclampsia at 17 weeks gestation. Ultrasound findings were consistent with a partial hydatidiform mole. Within 24 hours of the onset of symptoms, the patient developed severe hemolysis, elevated liver enzymes, and low platelet count syndrome, with a platelet count of 20 x 10 (9) cells/L. Termination of pregnancy was performed with rapid resolution of signs, symptoms, and laboratory abnormalities. Triploid 69,XXY was confirmed at karyotype analysis. This case demonstrates the acuteness in which life-threatening maternal conditions can arise with this uncommon complication of pregnancy, and the importance of correct identification of the characteristic ultrasonographic findings associated with a partial hydatidiform mole.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Induced
  • Adult
  • Diagnosis, Differential
  • Female
  • HELLP Syndrome / blood
  • HELLP Syndrome / diagnosis*
  • HELLP Syndrome / pathology
  • Humans
  • Hydatidiform Mole / diagnosis*
  • Hydatidiform Mole / diagnostic imaging
  • Hydatidiform Mole / genetics
  • Hydatidiform Mole / pathology
  • Pregnancy
  • Pregnancy Trimester, Second
  • Ultrasonography, Prenatal*
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / diagnostic imaging
  • Uterine Neoplasms / genetics
  • Uterine Neoplasms / pathology