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986 Partial hydatidiform mole with a living fetus: a need for a management guideline.-
  1. RAEA Hemida1 and
  2. K Zalata2
  1. 1Faculty of Medicine – Mansoura University كلية الطب جامعة المنصورة, Obstetrics and Gynecology, Mansoura, Egypt
  2. 2Faculty of Medicine – Mansoura University كلية الطب جامعة المنصورة, Pathology, Mansoura, Egypt


Introduction/Background*Partial mole (PM) results from dispermic fertilization of a normal oocyte and produces a triploid set of chromosomes and is commonly associated with the presence of congenital fetal malformations. Partial molar pregnancy with an existing live fetus is a very rare condition, occurring in 0.005 to 0.01% of all pregnancies. It is sometimes called “Sad Fetus Syndrome”. It presents a challenging diagnosis, especially when clinical signs are almost completely absent and a challenging management when the patient is interested to continue her pregnancy. Currently, there is no international guidelines for management.

Methodology A retrospective analysis of the patients presented with partial mole with a living fetus to our GTD clinic, Mansoura University, Egypt in the last 5 years. Clinical characteristics and outcome were described. An Excel sheet and SPSS program were used for statistical analysis.

Result(s)*From September 2015 to August, 2020; eleven cases of PM with living fetus were managed in our hospital. Mean age was 25.7 years while mean parity was 1.2. Amniocentesis was performed in one case and was normal. Duration of pregnancy ranged from 14 to 37 weeks. The fetal outcome was normal preterm fetus in two cases (18.2%), infantile death after 2 months because of congenital fetal malformations in one case, early neonatal death because of severe prematurity in two cases, and induction of abortion or hysterotomy because of complications in 6 cases.

Maternal complications occurred in 6 cases (54.5%); hemorrhage in 4 cases (36.4%), pre-eclampsia-eclampsia in two cases (18.2%), hyperemesis gravidarum in one case (9.1%), and postmolar gestational trophoblastic neoplasia (GTN) in one case (9.1%).

Moreover, three cases (27.3%) presents as familial recurrent hydatidiform mole with proved NLRP7 gene mutation in two.

Conclusion*Maternal and fetal outcome of partial molar pregnancy with a living fetus is poor. Counseling of the patients for termination of pregnancy may be need. A global guideline for management is required.

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