Trisomy 21 fetus co-existent with a partial molar pregnancy: case report.
BACKGROUND
Approximately 1 in 1,000 pregnancies in the United States are complicated by the presence of a hydatidiform mole. A Medline search revealed no reported cases of a trisomic fetus co-existent from 1966-1998. We present the case of a patient, initially found to have hypertension, edema, and proteinuria in the first trimester, and later found to have a partial molar gestation co-existent with a trisomy 21 infant.


METHODS
A 31-year-old female presented to her family practitioner in the first trimester and was found to have hypertension and proteinuria. A thorough work-up by a nephrologist revealed no cause. The patient was transferred to the Maternal-Fetal Medicine Service at 26 weeks' and 1 day estimated gestational age. An amniocentesis revealed the presence of a fetus with trisomy 21. At 27 weeks' and 3 days estimated gestational age, the patient underwent a cesarean delivery for a non-reassuring fetal heart rate. Pathologic examination of the placenta revealed the presence of a partial hydatidiform molar pregnancy.


CONCLUSIONS
The present account represents the first reported case of a fetus with trisomy 21 co-existent with a partial hydatidiform mole.
Geisler
J P
JP
Department of Obstetrics and Gynecology, St. Vincent Hospitals and Health Services, Indianapolis, Indiana, USA.
Mernitz
C S
CS
Hiett
A K
AK
Geisler
H E
HE
Cudahy
T J
TJ
D000328:Adult; D004314:Down Syndrome; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole; D008297:Male; D011247:Pregnancy; D014594:Uterine Neoplasms