Partial hydatidiform mole and coexistent live fetus with placenta previa: a case report

Ann Med Surg (Lond). 2023 Apr 3;85(5):2020-2023. doi: 10.1097/MS9.0000000000000492. eCollection 2023 May.

Abstract

Partial molar pregnancy with a coexistent live fetus is very rare. This type of mole mostly ends in the early termination of pregnancy due to an abnormally developed fetus.

Case presentation: Here, we report a case of a 24-year-old Indonesian woman with an ultrasonographic appearance of partial hydatidiform mole with initial placenta covering the internal uterine ostium in the late first trimester which then became marginal placenta previa in the third trimester. The woman decided to continue the pregnancy after considering the risks and benefits. The normal anatomy of the premature infant was vaginally delivered alive with a large and hydropic placenta.

Clinical discussion: Proper diagnosis, management, and monitoring remain challenging as this case is still rarely reported. Although embryos from partial mole forms generally do not survive since the first trimester, our case reported the singleton pregnancy with the coexistent normal fetus and the partial mole characteristic of the placenta. Diploid karyotype, few and focal extent of hydatidiform tissue of placenta, low rate of molar degeneration, and the absence of fetal anemia hypothesized as the factors that influenced survival of the fetus. There were two maternal complications such as hyperthyroidism and frequent vaginal bleeding without subsequent anemia in this patient.

Conclusions: A rare case of partial hydatidiform mole coexistent with a live fetus with placenta previa was reported in this study. There were also maternal complications. Thus, prompt and regular monitoring of maternal and fetal condition holds an important role.

Keywords: case report; normal live fetus; partial hydatidiform mole; partial molar pregnancy; partial mole.