Partial Molar Pregnancy Research Articles

Vaginal Lesion with Placental Site Trophoblastic Tumor after Partial Molar Pregnancy A Case Report

Background: Gestational trophoblastic neoplasia (GTN) is a rare disease developing after normal or molar pregnancy. Clinical presentation can be heterogenous while early detection of GTN is crucial for treatment success. We report a rare case with vaginal location of placental site tumor (PSTT) after suction curettage of partial molar pregnancy.

Gestational Trophoblastic Neoplasia After Human Chorionic Gonadotropin Normalization Following Molar Pregnancy: A Systematic Review and Meta-analysis.

To estimate the incidence of gestational trophoblastic neoplasia following complete and partial molar pregnancy after reaching normal human chorionic gonadotropin (hCG) levels to guide evidence-based follow-up recommendations. MEDLINE, EMBASE, Web of Science, POPLINE, Cochrane, and ClinicalTrials.gov were searched from inception to November 2018, using the intersection of "gestational trophoblastic disease," "molar pregnancy," and "human chorionic gonadotropin" themes. Search results were screened to identify cohort studies of molar pregnancy reporting gestational trophoblastic neoplasia development, with at least 6 months of intended normal hCG follow-up. Two reviewers independently identified articles for inclusion. Data were extracted using a standardized form. For meta-analysis, cumulative incidence of gestational trophoblastic neoplasia, with CIs by the Agresti-Coull method, and pooled risk ratios (RRs) comparing complete and partial mole were calculated. Among the 19 eligible studies that reported adequate data for inclusion in the primary meta-analysis, we found low incidence of gestational trophoblastic neoplasia after normal hCG level following both complete mole (64/18,357, 0.35%, 95% CI 0.27-0.45%), and partial mole (5/14,864, 0.03%, 95% CI 0.01-0.08%). There was a significantly higher risk of gestational trophoblastic neoplasia after complete compared with partial molar pregnancy (RR 4.72, 95% CI 1.81-12.3, P=.002). Among gestational trophoblastic neoplasia cases after normal hCG level following complete mole, 89.6% occurred when the time from evacuation to normalization was 56 days or longer, and 60.7% were diagnosed beyond the commonly recommended 6-month surveillance interval. Sensitivity analyses, including those limiting to studies at low risk of bias, did not significantly affect results. We found an overall incidence of gestational trophoblastic neoplasia of 15.7% for complete mole (1,354/8,611, 95% CI 15.0-16.5%) and 3.95% for partial mole (221/5,593, 95% CI 3.47-4.50%). Gestational trophoblastic neoplasia development after normal hCG level following molar pregnancy is rare. Recommendations for frequency and duration of hCG follow-up can be minimized to lessen burden on patients and informed by the type of molar pregnancy and time interval from uterine evacuation to hCG normalization. PROSPERO, CRD42019116414.

Partial Hydatidiform Mole and Coexistent Live Fetus: A Case Report and Review of the Literature.

Twin pregnancy of a hydatidiform mole with a coexistent live fetus is very rare, and complete molar pregnancy is involved in most cases. A partial molar pregnancy almost always ends in miscarriage due to a triploid fetus. Here, we report a case of a 32-year-old Chinese woman with ultrasound diagnosis of a partial molar pregnancy. Amniocentesis suggested mosaicism, but the fetus was morphologically normal. The woman chose to continue the pregnancy after fully understanding the risk. The infant was delivered prematurely, and the presence of a large single placenta with molar changes. The baby’s peripheral blood chromosomes were diploid, and the pregnant woman had no serious complications. The diagnosis, management, and monitoring of this condition will remain challenging because of its rarity. Partial hydatidiform mole combined with pregnancy can result in delivering of a normal fetus and live birth under proper management.

Diagnosis and Management of Placental Mesenchymal Disease. A Review of the Literature.

To review what is currently known about placental mesenchymal dysplasia (PMD) including imaging techniques for diagnosis and differentiation from a molar pregnancy, genetics, maternal/fetal effects, and management. A literature search by research librarians at 2 universities was undertaken using the search engines PubMed and Web of Science. The search terms used were "etiology" OR "cause" OR "risk" OR "risks" OR "epidemiology" OR "diagnosis" OR "therapy" OR "prognosis" OR "management" AND "placental mesenchymal dysplasia" OR "placenta" AND "mesenchymal dysplasia." No limit was put on the number of years searched. The etiology of PMD remains uncertain, although there are a number of theories on causation. An elevated maternal serum α-fetoprotein level, slightly elevated human chorionic gonadotropin level, normal karyotype, multicystic lesions on ultrasound, and varying degrees of flow within cysts using color Doppler (stained-glass appearance) are helpful in making the diagnosis. On pathologic examination of the placenta, PMD is differentiated from molar pregnancy by the absence of trophoblastic hyperplasia. Fetal complications of PMD include hematologic disorders, Beckwith-Wiedemann syndrome, liver tumors, fetal growth restriction, preterm delivery, and intrauterine fetal demise. Maternal complications include gestational hypertension, preeclampsia, HELLP (hemolysis, elevated liver function tests, low platelets) syndrome, and eclampsia. Accurate diagnosis of PMD is imperative for appropriate management and surveillance to minimize adverse maternal and fetal outcomes. The importance of a correct diagnosis of PMD is important because it can be misdiagnosed as a partial molar pregnancy or a complete mole with coexisting normal fetus, and this can result in inappropriate management.

EP28.28: Partial molar pregnancy and coexisting live fetus with normal karyotype: the dilemma of management and prenatal diagnosis

EP28.28: Partial molar pregnancy and coexisting live fetus with normal karyotype: the dilemma of management and prenatal diagnosis

A surprising presentation of a partial hydatidiform molar pregnancy in rudimentary horn of unicornuate uterus

A surprising presentation of a partial hydatidiform molar pregnancy in rudimentary horn of unicornuate uterus - IJOGR- Print ISSN No: - 2394-2746 Online ISSN No:- 2394-2754 Article DOI No:- 10.18231/j.ijogr.2019.087, Indian Journal of Obstetrics and Gynecology Research-Indian J Obstet Gynecol Res

Single-nucleotide polymorphism microarray detects molar pregnancies in 3% of miscarriages

To determine the frequency of molar pregnancy in miscarriage cases based on single-nucleotide polymorphism (SNP) microarray testing on products of conception (POC) tissue and to estimate the sensitivity of ultrasound and histopathologic evaluation for cases identified to be at risk for gestational trophoblastic disease. Retrospective cohort analysis. Reference laboratory. POC specimens from 26,101 consecutive miscarriages. POC samples were sent to a single laboratory for analysis. Maternal age, gestational age, egg donor use, indication for testing, and additional clinical information were obtained from the requisition form and a survey sent to ordering providers. Rates of full paternal uniparental disomy (UPD), indicative of complete molar pregnancy, and triploidy of paternal origin, indicative of partial molar pregnancy, in POC samples. Paternal triploidy was detected in 638 cases (2.8%) and full paternal UPD in 72 cases (0.3%). Of the cases with complete clinical information (224/710; 31.5%), histopathology and/or ultrasound did not detect 71% of partial molar pregnancies and 30% of complete molar pregnancies. Molar pregnancy, detected in 3.1% of all miscarriages in this study with the use of 24-chromosome SNP microarray testing, occurred significantly more frequently than previously estimated with the use of ultrasound and/or histopathology.

A partial molar pregnancy associated with a fetus with intrauterine growth restriction delivered at 31 weeks: a case report

IntroductionMolar pregnancies belong to a group of diseases classified as gestational trophoblastic diseases, which result from an altered fertilization. Partial molar pregnancy with a live fetus is a very rare condition, occurring in 0.005 to 0.01% of all pregnancies; it presents a challenging diagnosis, especially when clinical signs are almost completely absent.Case presentationHere we report a rare case of partial molar pregnancy in which a normal-appearing male fetus with diploid karyotype was delivered at 31 weeks gestation by a 37-year-old white woman. The pregnancy was characterized by an episode of threatened abortion in the first trimester and an ultrasonographic diagnosis of intrauterine growth restriction. Our patient did not report any suspicious symptoms for trophoblastic disease. Due to impaired umbilical artery velocimetry with an absence of the diastolic phase, she underwent an emergency caesarean section at 31 weeks and delivered an 880 g male baby. The male baby was normal without any complications at 3-month and 12-month follow-up and the mother had no evidence of recurrence after 3 and 12 months of follow-up. Pathological examination of the placenta showed changes of partial hydatidiform mole.ConclusionPartial molar pregnancy with a live fetus is a very rare condition that presents a challenging diagnosis. Recognizing it is of primary importance for patient care and the placenta should always be investigated at birth, especially in a newborn with intrauterine growth restriction.

Histological Study of Molar Pregnancy by using some of the Special Stains

Background: Molar pregnancy (hydatidiform mole HM) is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus and will fail to come to term. A molar pregnancy is a gestational trophoblastic disease which grows into a mass in the uterus that has swollen chorionic villi. These villi grow in clusters that resemble grapes. A molar pregnancy can develop when a fertilized egg does not contain an original maternal nucleus. The diagnosis of HM is based on its morphology. In classic cases, the abnormally large villi have a vesicular or a grape like appearance. Histologically, HM presents variable degrees of circumferential trophoblastic hyperplasia and epithelial atypia. Distinguish between complete mole (CM) and partial mole (PM) is difficult especially with early diagnosis and evacuation of molar pregnancies, however, the criteria are subjective and show considerable inter-observer variability. Unfortunately in our country the histological diagnosis is depend only on routine stain (H&E) which is not giving a clear results in some cases because of that, the study design to find the similarities and differences between the two types of molar pregnancy by using some of special stains which surely distinguish between complete and partial moles samples using immunohistochemical marker P57KIP2. Objective: To detecting if the special stain can be helpful to distinguish between the two types of molar pregnancy also to find the accuracy of the routine diagnosis of hydatidiform mole comparing with P57 immunohistochemistry stain. Patients and Methods: The study conducted at the maternal teaching hospital in Erbil city. Thirty cases of Molar Pregnancy diagnosed, 15 of them were complete and the others were partial mole. All the samples studied histologically using H&E and some of special stains including: PAS stain, Congo red, and Trichrom, to describe the morphological differences between the two types of mole. Also immunohistological P57 stain was used in this study to confirm the type of mole. Results: The study result shows the morphological variation between complete and partial hydatidiform through using the routine H&E stain and special stains. The complete hydatidiform mole sections showed vesicular swelling of chorionic villi and circumferential trophoblastic hyperplasia, the trophoblastic proliferation grade varying in complete samples, most samples showed grade II (46.6%) of trophoblastic proliferation, while few of samples showed grade III (13.3%). The cases of partial hydatidiform mole showed scattered hydropic villi with irregular scalloped villous outlines and mild trophoblastic hyperplasia, trophoblastic distribution elucidate that the majority (60%) of samples show zonal distribution and high percentage (73.3%) of focal trophoblastic proliferation. The vessels in the villous stroma of most of partial molar samples (80%) was obviously seen also the cistern appear clearly in 73.33% of the samples and all partial molar pregnancy samples showed presence of fetal part in contrast to complete mole. The PAS stain show no different between the two types of molar pregnancy samples while the Congo red stained the partial molar samples intensely comparing with complete samples opposite to the trichrome stain which showed highly color intensity in complete than in partial samples. In this study the most important noticed results was high percentage (26.66) of positive result of P57 in complete diagnosed sample by routine way. Conclusion: The special stains can be helpful in diagnosis of hydatidiform mole and The study of p57 immunohistochemistry stain indicate present of misread in routine diagnoses of complete hydatidiform due to mimic morphological characters.

A Comparison of the Clinical Presentation of Ovarian Hyperstimulation Syndrome in a Partial Molar Pregnancy Case Versus a Fertility Treatment Case

Ovarian hyperstimulation syndrome (OHSS) is ovarian enlargement secondary to hormones overstimulating ovarian growth. It can be associated with a spectrum of other clinical findings, including ascites, hemoconcentration, hypercoagulability, and electrolyte imbalances. OHSS most commonly occurs as a complication of treatment with in vitro fertilization medications, such as human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone agonists. OHSS has infrequently been reported to be caused by high hCG levels in complete, partial, or invasive molar pregnancies. The classic signs and symptoms of OHSS include nausea, vomiting, bloating, abdominal pain, tachycardia, tachypnea, and dyspnea. Further positive diagnostic studies for OHSS include enlarged ovaries, ascites, hemoconcentration, hyponatremia, hyperkalemia, and oliguria. OHSS due to molar pregnancies is extremely rare. Suziki et al. performed a literature review in 2014 and describe the eight ever-reported molar pregnancy-associated OHSS cases, three of which were partial molar pregnancies. We present a two-case comparison that first examines an exceptionally rare OHSS case presentation of a 19-year-old female with a partial molar pregnancy that was also complicated by hCG-induced thyrotoxicosis. Following this, we discuss a case of the more classic presentation of OHSS caused by fertility treatments. This case report is of novel interest because we present a case comparison that emphasizes a rare, paradoxical association between OHSS and dilation-evacuation procedures that is important for physicians to be aware of - OHSS is not an adverse event of molar pregnancies that can be eliminated by declining hCG levels after a dilation and evacuation procedure; rather, in a molar pregnancy, OHSS occurs after the dilation and evacuation.

Gestational Trophoblastic Disease at Sultan Qaboos University Hospital: Prevalence, Risk Factors, Histological Features, Sonographic Findings, and Outcomes.

ObjectivesWe sought to assess the prevalence of gestational trophoblastic diseases (GTD) among pregnant women at Sultan Qaboos University Hospital (SQUH) and compare our results with the international studies. We also sought to determine the risk factors, histological features, sonographic findings, and outcomes in women with GTD.MethodsWe conducted a retrospective cohort study of all women diagnosed with GTD and followed at SQUH between November 2007 and October 2015. We collected data on maternal demographics, risk factors, sonographic features, histological diagnosis, follow-up period, and chemotherapy treatment from the hospital information system.ResultsSixty-four women with GTD were included in the study with a mean age of 31.0±7.5 years, mean gravidity 4.0, and parity 2.0. The prevalence of GTD was 0.3% (one in 386 births), and the most common risk factors were increased maternal age and multiparity. A partial hydatidiform mole was diagnosed in 54.7%, complete hydatidiform mole in 43.8%, and invasive mole in 1.6% of women. Eleven percent of women required chemotherapy. Typical ultrasound features for partial molar pregnancy were present in 54.7% of our sample, while snowstorm appearance was seen in 89.3% of those with complete mole. Negative beta-human chorionic gonadotropin was achieved 70 days after diagnosis in 41 women.ConclusionsThe awareness of the risks and complications of GTD among physicians with close follow-up is paramount. There is a need to establish a national registry of GTD cases in Oman.

Partial Mole Coexistence with a Normal Live Fetus in Twin Pregnancy

We present a case of dizygotic diamiontic twin pregnancy in which one fetus was normal with normal placenta, the 2nd fetus was normal appearing with partial molar placenta. All required investigation and clinical assessments were carried out and revealing partial molar pregnancy in one fetus and normal placenta of the other one. Maternal BhCG was high for gestational age.The patient was a 31-year-old presented to Central Private Hospital; her gestational age was 22 weeks +5 days following IVF (after 10 years of primary infertility) of diazygotic diamiontic twin pregnancy as a case of vaginal bleeding from 8 weeks of gestation with uterine contractions.
 The patient had gestational DM & hyperthyroidism. Appropriate treatment regarding her conditions was implemented
 All appropriate management was implemented. The patient continued to bleed. Within few days of admission she had premature uncomplicated labor with normal vaginal delivery (gestational age was23 Wks +3 days), both babies appeared normal, one placenta morphologically &histologically typical of H.mole. The other one completely was normal.
 Monitoring of serum BhCG and follow up transvaginal US was done until BhCG level returned to normal after 3 months of delivery without chemotherapy.
 Close monitoring of pregnancy from early stages and discussing the possible complications to mother and baby (such as baby may be chromosomally abnormal &may not survive) with parents is important to manage such complications.
 It is also necessary to have post-natal close follow up for maternal BhCG levels to assess any possibility of invasive mole or choriocarcinoma.

Abstract #645 Thyrotoxicosis from Partial Molar Pregnancy

Abstract #645 Thyrotoxicosis from Partial Molar Pregnancy

Placental mesenchymal dysplasia: An underdiagnosed placental pathology with various clinical outcomes

BackgroundPlacental mesenchymal dysplasia (PMD) is a rare vascular and connective placental anomaly, which is often associated with severe fetal and/or maternal complications. The diversity of presentation of PMD challenges diagnosis and effective pregnancy management. ObjectiveWe aimed to review cases presenting at 7 tertiary centers worldwide over the last decade and to study the occurrence of obstetric and neonatal complications. Study designPathology databases from 7 tertiary hospitals were screened for cases of PMD (between 2007–2017). Pregnancy history, outcomes and ultrasound images were then reviewed for each case. ResultsTwenty-two cases of PMD were identified. Mean gestational age at diagnosis was 23 weeks (16–39 weeks). Prenatal biochemical screening was abnormal in 8 cases (36%). Of the 12 cases that underwent invasive genetic testing, 4 were abnormal. Six patients (27%) developed maternal complications (preeclampsia/gestational hypertension). Fetal growth restriction was identified in 11 cases (50%) and fetal death in 4 (18%). Four (18%) pregnancies were terminated, 9/14 (64%) delivered preterm and only three (14%) progressed normally. Fourteen babies were born alive; 5 (35%) died in the first sixty-one days after birth, 5 (35%) had transient thrombopenia and 1 (7%) had developmental delay at last follow-up. Our series identified four potential new associations with PMD: placental triploidy mosaicism, CHARGE syndrome, fetal pleuropulmonary blastoma and fetal skeletal dysplasia. ConclusionsPMD was substantially under-diagnosed before delivery in this cohort. Sonographers, fetal medicine specialists, obstetricians and pathologists should all suspect PMD in cases of an enlarged placenta and should look for fetal abnormalities. Diagnostic genetic testing should be discussed to exclude partial molar pregnancy. Close pregnancy follow-up is indicated due to the high risk of associated fetal or maternal adverse outcomes.

CASE REPORT: AN INCOMPLETE MOLAR PREGNANCY WITH UNUSUAL COMPLICATIONS

ABSTRACTINTRODUCTION: Gestational trophoblastic diseases (GTD) are a heterogeneous group of gestational and neoplastic conditions arising from the trophoblast. It is uncommon for gestational trophoblastic disease to present with Preeclampsia and syndrome prior to 24 weeks gestation. CASE PRESENTATION We present an unusual case of partial molar pregnancy which was diagnosed with severe preeclampsia and Partial HELLP associated with Severe anemia, Sepsis, Hyperthyroidism, Thrombocytopenia & CHF at 03 months of amenorrhea with ultrasound and Histopathology confirmed an incomplete molar pregnancy. Evacuation of the Uterus resulted in rapid resolution of signs, symptoms, and laboratory abnormalities. CONCLUSION This case demonstrates the acuteness in which life-threatening maternal conditions can arise with this uncommon complication of pregnancy, and the importance of early & correct identification of the characteristic laboratory & ultrasonographic findings associated with a molar pregnancy.kEY WORDS: Molar pregnancy, Preeclampsia, HELLP syndrome (Ethiopian Journal of Reproductive Health; 2019; 11;1:71-77)

Conservative Management, Follow-up and Perinatal Outcomes After Gestational Trophoblastic Disease with Coexistent Normal Fetus: Case Report

Background: Gestational trophoblastic disease (GTD) is the consequence of a genetic alteration that happens during fecundation. Is the term used to describe malignant lesions that originates in the chorionic villi an extra villous trophoblast. Molar pregnancies can be subdivided into complete (CM) and partial moles (PM) based on genetic and histopathological features. Case report: 23-year old patient, who presents an ultrasound which revealed a singleton pregnancy with no fetal structural abnormalities, and fetal biometry consistent with gestational age (16w + 6d). There was a placenta with focal areas of enlargement associated with numerous lucent cyst, and normal amniotic fluid, compatible with partial molar pregnancy in association with a normal fetus. After risks of subsequent fetal and maternal complications were explained to the patient and her family, it was elected to continue with her pregnancy; patient went under cesarean delivery at 31w 3d because low amniotic fluid levels (oligohydramnios) and abnormal fetal well-being tests.

Singleton Partial Molar Pregnancy Delivered in Third Trimester: A Case Report

Background: A partial mole is the result of fertilization of a haploid ovum by two sperms or duplication of one sperm, resulting in a triploid karyotype (69 XXY, 69 XXX, 69 XYY). To date, there are very few cases of histo-pathologically confirmed partial moles with diploid karyotypes which survived. This case is reported to highlight the rarest variant of partial molar pregnancy. Case presentation: Here we present a case of singleton partial molar pregnancy co-existing with a live fetus delivered to an 18 years old primigravida lady at Jimma university medical center (JUMC) after amenorrhea of 8 months. She presented with eclamptic seizure for which she was admitted with a diagnosis of Eclampsia in 3rd trimester pregnancy. Malpresentation (breech) with? Abruptio placenta to rule out partial mole was considered initially. Cesarean section (C/S) was done to effect delivery of an alive female neonate weighing 1100 gm with an APGAR score of 4, 6 & 7 at 1st, 5th & the 10th minute of life. The neonate is admitted to neonatal intensive care unit (NICU) where she is complicated by early neonatal death after 65 hours of stay despite many efforts, the possible cause of death being respiratory failure secondary to underlying prematurity. Grossly placenta was single, weighing 1200 gm and invaded by vesicles except its membrane. Histo-pathological finding of placenta was consistent with partial mole. Conclusion: The optimal management of hydatidiform mole with coexistent live fetus is currently uncertain. Clinicians are recommended to present their individual cases for the establishment of guidelines for the management and prenatal counseling for pregnancies with partial mole with coexistent fetuses.

Pregnancy Outcomes in Patients Treated with Bosutinib

Introduction: Studies in animals have shown reproductive toxicity with bosutinib exposure, with teratogenic events in maternal exposure, but little is known about its effect during conception or pregnancy in humans.Methods: Here we describe pregnancy outcomes in bosutinib-treated patients from the Pfizer safety database, which includes cases from both clinical trials and spontaneous reports. Pregnancy cases reported up to February 28, 2018 were identified by searching the database using the Standardized MedDRA Query Pregnancy and Neonatal Topics in patients receiving bosutinib.Results: The database search identified 33 relevant pregnancy reports, including 17 cases of exposure via the father and 16 cases of maternal exposure. Among the 16 cases of maternal exposure, 5 vaginal deliveries of healthy babies, 2 patient-requested induced abortions, 1 spontaneous abortion, and 1 partial molar pregnancy requiring a dilation and curettage were reported. In 1 case, the patient was reported to have delivered a baby, but the details of the status of the baby was not provided. Outcomes in 6 cases are unknown. Of the healthy deliveries, 4 pregnancies went to full term (≥39 weeks) and 1 was of unknown duration; bosutinib was discontinued during the first trimester of pregnancy in all 5 cases. The reported spontaneous abortion was due to a suspected ectopic pregnancy in a 34-year-old patient who began taking bosutinib 500 mg once daily while pregnant and was thought to be unrelated to bosutinib exposure.Of the 17 cases of exposure via father, 8 vaginal deliveries of healthy babies, 1 Caesarean section delivery of a healthy baby, 4 induced abortions, and 1 spontaneous abortion were reported. The remaining 3 cases had unknown outcomes. Of the 4 induced abortions, 1 was elective due to an unintended pregnancy, and 2 were due to unknown reasons. In the last case, it was reported that the fetus was not growing properly and that the pregnancy would subsequently be terminated; no confirmation of congenital abnormality or further information is available. The reported spontaneous abortion was thought to be unrelated to bosutinib; fetal biopsy revealed basal deciduitis with necrosis loci and bleeding.Conclusions: Overall, a review of the available experience with bosutinib in pregnancy did not identify any safety signals. However, adverse effects of bosutinib exposure at conception or during pregnancy in humans cannot be ruled out, particularly if therapy is not interrupted upon recognition of pregnancy. Bosutinib is not recommended for use during pregnancy, and patients on bosutinib treatment should use effective contraception. DisclosuresCortes:Astellas Pharma: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Daiichi Sankyo: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Arog: Research Funding. Gambacorti-Passerini:BMS: Consultancy; Pfizer: Consultancy, Honoraria, Research Funding. Deininger:Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees; Blueprint: Consultancy. Abruzzese:Novartis: Consultancy; Ariad: Consultancy; BMS: Consultancy; Pfizer: Consultancy. DeAnnuntis:Pfizer Inc: Employment, Equity Ownership. Brümmendorf:Janssen: Consultancy; Merck: Consultancy; Novartis: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Takeda: Consultancy.

Partial molar pregnancy in the cesarean scar: A case report and literature review: Erratum.

Partial molar pregnancy in the cesarean scar: A case report and literature review: Erratum.

220. Exceedingly rare presentation of gestational trophoblastic disease: Molar pregnancy implantation in Caesarean scar

Introduction Gestational trophoblast disease (GTD) forms a spectrum of illnesses that are rare, almost always highly curable, but not always well understood by non-specialists. The types of trophoblast disease range from the usually benign partial molar pregnancy through complete molar pregnancy and invasive mole to the malignant choriocarcinoma and placental site trophoblast tumours. All of these illnesses share the characteristic that they arise from a pregnancy. While ectopic pregnancy may occur in 11:1000 pregnancies (mortality 1.7 per 10,000 cases caesarean scar ectopic is an extremely rare condition with an incidence of between 1:1800 and 2216 pregnancies. The coexistence of these two conditions have not been reported in Australia with only a handful described internationally. Methods Case report. Results I present the case of a 34 year old multiparous lady presented with the unfortunate diagnosis of a molar pregnancy implanted in her caesarean scar. She was initially treated at a metropolitan centre before requiring transfer to a specialist unit. Discussion I discuss the clinical manifestations, appropriate diagnostic tools and management of this extremely unusual and unexpected clinical case.