Preeclampsia and fetal triploidy: a rarely reported association in nephrologic literature.
We report a case of a healthy woman - whose previous pregnancy was uncomplicated - with early onset of hypertension, proteinuria and edema, during her second pregnancy. Ultrasound examination at 19th week of amenor rhea showed a fetus with growth retardation, corresponding to 17 weeks' gestation, ascites, cardiomegaly with serious multiple congenital anomalies. Amniocentesis for fetal karyotyping revealed 69, XXX. Because of continued elevated blood pressure, increasing proteinuria and severe lethal fetal anomalies, interruption of pregnancy was suggested. It was subsequently carried out by surgery. The patient underwent renal biopsy 10 days post-partum: histology showed the presence of the characteristic pathologic renal changes of preeclampsia. A year later, she became pregnant by the same partner. The third pregnancy was uneventful. The combination of fetal triploidy and preeclampsia may suggest a causative relationship. Clinically, most cases manifest as severe early-onset preeclampsia and must be differentiated from essential hypertension and a chronic glomerulonephritis (GN), which becomes symptomatic during pregnancy. When a fetus has triploidy, the counseling should stress the high incidence of preeclampsia; particularly when fetal anomaly is not compatible with life, it is well known that delivery of the fetus is curative in this syndrome. This information is important in counseling patients who are hesitant to terminate the pregnancy purely for a fetal abnormality, even if lethal.
Giannattasio
Michele
M
Nephrology and Dialysis Unit, Santa Maria degli Angeli Hospital, Putignano, Bari, Italy. michele.giannattasio@libero.it
Gernone
Giuseppe
G
Pannarale
Giovanni
G
Gesualdo
Loreto
L
Schena
Francesco Paolo
FP
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005313:Fetal Death; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007621:Karyotyping; D007668:Kidney / Q000473:pathology*; D011123:Polyploidy; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000209:etiology*; D011247:Pregnancy