Acute onset of severe hemolysis, elevated liver enzymes, and low platelet count syndrome in a patient with a partial hydatidiform mole at 17 weeks gestation.
Preeclampsia is uncommon prior to 24 weeks gestation and has been associated with partial and complete hydatidiform moles. We present an unusual case in which a patient was diagnosed with preeclampsia at 17 weeks gestation. Ultrasound findings were consistent with a partial hydatidiform mole. Within 24 hours of the onset of symptoms, the patient developed severe hemolysis, elevated liver enzymes, and low platelet count syndrome, with a platelet count of 20 x 10 (9) cells/L. Termination of pregnancy was performed with rapid resolution of signs, symptoms, and laboratory abnormalities. Triploid 69,XXY was confirmed at karyotype analysis. This case demonstrates the acuteness in which life-threatening maternal conditions can arise with this uncommon complication of pregnancy, and the importance of correct identification of the characteristic ultrasonographic findings associated with a partial hydatidiform mole.
Sherer
David M
DM
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, 445 Lenox Road, Brooklyn, NY 11203, USA.
Dalloul
Mudar
M
Stimphil
Raphael
R
Hellmann
Mira
M
Khoury-Collado
Fady
F
Osho
Joseph
J
Fomitcheva
Larissa
L
Brennan
Kelly J
KJ
Abulafia
Ovadia
O
D000028:Abortion, Induced; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D017359:HELLP Syndrome / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology