The ultrasound diagnosis of hydatidiform mole and coexistent fetus associated with elevated maternal serum alpha feto protein

Abstract

A 36-year-old primigravida was seen in the antenatal clinic. At this stage gestation was ten weeks by dates but the uterus was slightly larger on examination. Four weeks later the patient was found to be hypertensive (BP 180/120) and had experienced persistent vomiting for two weeks. On ultrasound scan a large placenta containing vesicles was demonstrated, and, lying low down in the uterus, a viable fetus of approximately 15 weeks gestation was visible. The maternal serum α feto protein level (AFP) at this stage was 164 μg/1 (normal median value at 15 weeks 31 μg/1 Median × 2.5 78 μg/1. Liverpool University). In view of these findings the patient was admitted for termination. Post mortem revealed a 15-week fetus with a large spina bifida defect. The placenta showed hydropic changes consistent with hydatidiform mole.