Pre-eclampsia and peripartum cardiomyopathy in molar pregnancy: clinical implication for maternally imprinted genes.
Molar pregnancies are associated with increased maternal complications, notably pre-eclampsia, but peripartum cardiomyopathy has been rarely observed. Here we report on a 34-year-old woman, gravida 2 para 1, who presented to our obstetric clinic for routine screening at 16 weeks of gestation. Elevated maternal serum alpha-fetoprotein and free beta-human chorionic gonadotropin were observed. Amniocentesis revealed a triploid constitution (69,XXX) and ultrasound examination showed growth restriction, fetal anomalies, placentomegaly and a total placenta previa. On admission at 18 weeks' gestation, the patient developed vaginal bleeding and pre-eclampsia. She underwent a Cesarean delivery and 6 h later developed congestive heart failure requiring intensive care support. Molecular analysis of the conceptus and parental DNA demonstrated an excess of paternal genomic contribution. The over-representation of the paternal chromosome complement may support the role of genomic imprinting in the clinical course of this case.
Billieux
M-H
MH
Department of Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
Petignat
P
P
Fior
A
A
Mhawech
P
P
Blouin
J-L
JL
Dahoun
S
S
Vassilakos
P
P
D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000032:analysis; D005260:Female; D005317:Fetal Growth Retardation / Q000235:genetics; D005333:Fetus / Q000002:abnormalities; D018392:Genomic Imprinting / Q000235:genetics*; D006333:Heart Failure / Q000235:genetics*; D006801:Humans; D006828:Hydatidiform Mole / Q000235:genetics*; D010923:Placenta Previa / Q000235:genetics; D011225:Pre-Eclampsia / Q000235:genetics*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011654:Pulmonary Edema / Q000209:etiology; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000235:genetics*; D000509:alpha-Fetoproteins / Q000032:analysis
D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins