Unsuspected partial hydatidiform moles discovered at laparotomy: A case report

Abstract

Gestational trophoblastic disease which develops from placenta and can metastases, involves hydatidiform mole also known as molar pregnancy. It’s extremely rare to have a pregnancy involving hydatidiform mole and a live fetus. A 30-year-old Javanese woman, gravida 2, para 1, referred to Temanggung Hospital who experienced uterine contractions and vaginal bleeding at 32 weeks’ gestation was considered to have placenta previa. A 2 cm cervical dilation was found during genital exam, along with a cluster of blackish red little grape-like vesicles from her vagina She has never had ultrasound examination. We decide to do emergency cesarean section with their consent. Following spinal anesthesia, the patient experienced an episode of generalized tonic-clonic seizure then she was lost consciousness and needed to be intubated. Later, for mechanical ventilation, she was sent to the ICU. a 950 g, 40 cm long male newborn was delivered with Apgar scores of 6, 6, and 7 respectively at the 1,5, and 10-minute. He was taken right away to the NICU. The placenta which was large and hydropic was recovered manually. Diagnosis was confirmed by histopathology. Ultrasound is the main method for diagnosing hydatidiform moles. There were just a few changes to the villous vesicles in PHM patients and the majority of pregnancies ended in abortion and fetal death. Despite the extremely low occurrence of the illness, this case is significant since PHM recognition and diagnosis are crucial for patient management. When delivering a live fetus with a hydatidiform mole, a caesarean section is advised because uterine contractions might drive hydatidiform tissue into the abdominal cavity, increasing the risk of pulmonary embolism. Under careful management, a partial hydatidiform mole and pregnancy can lead to the delivery of a healthy fetus and a live birth.