Eclampsia complicating hydatidiform molar pregnancy with a coexisting, viable fetus. A case report.
BACKGROUND
Eclampsia is a rare and serious complication of pregnancy. The occurrence of preeclampsia prior to the 20th week of gestation has been associated with concurrent hydatidiform molar pregnancy. We present a case of eclampsia complicating a partial molar pregnancy associated with a viable fetus.


METHODS
A 22-year-old white woman, gravida 1, para 0, at 14 weeks' gestation, presented with an excruciating headache associated with hypertension, proteinuria and a viable intrauterine fetus with gastroschisis. Subsequently the patient had a generalized tonic-clonic seizure which resolved with magnesium sulfate therapy. Markedly elevated quantitative human chorionic gonadotropin and a moderately thickened placenta were the sole clinical features suggestive of a molar gestation. Dilation and evacuation was performed revealing unremarkable products of conception. Pathologic and cytogenetic analyses revealed a triploid fetus (69,XXX) consistent with partial molar pregnancy.


CONCLUSIONS
Development of preeclampsia/eclampsia prior to 20 weeks of gestation should prompt a clinical evaluation to exclude the possibility of an underlying hydatidiform molar pregnancy.
Ramsey
P S
PS
Department of Obstetrics/Gynecology, Mayo Medical Center, Rochester, Minnesota 55905, USA.
Van Winter
J T
JT
Gaffey
T A
TA
Ramin
K D
KD
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D002869:Chromosome Aberrations; D004461:Eclampsia / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications* / Q000235:genetics / Q000473:pathology; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D012640:Seizures
D006063:Chorionic Gonadotropin