title: Live-born diploid fetus complicated with partial molar pregnancy presenting with pre-eclampsia, maternal anemia, and seemingly huge placenta: A rare case of confined placental mosaicism and literature review.
abstract: A partial molar pregnancy almost always ends in miscarriage due to a triploid fetus. We describe a rare case of a singleton, partial molar pregnancy with a seemingly huge placenta, which continued to delivery of a live-born diploid baby. A 27-year-old primigravida suffered from severe pre-eclampsia and progressive anemia. The uterus was enormously enlarged for the gestational age. A cesarean section was performed because of deterioration of maternal status at 25 weeks' gestation, when more than 3000 mL blood spouted concurrently with the delivery of the placenta. The histological examination showed congestion in the decidua, which indicated disturbance of maternal venous return from the intervillous space. The chromosome complement of the placenta and the neonate were 69,XXX and 46,XX, respectively. We also reviewed all published cases of a singleton, partial molar pregnancy. A literature search yielded 18 cases of a singleton, diploid fetus with partial molar pregnancy. The mean gestational age at delivery was 24.5 ± 6.2 weeks, and fetuses survived outside the uterus in only four cases (22.2%). Intriguingly, previous reports numbered 10 cases with diploid placenta as well as five cases with no karyotyping of the placenta, indicating that they may have included a complete mole in a twin pregnancy or placental mesenchymal dysplasia. In conclusion, this was the first case of placentomegaly that presented manifestations of excessive abdominal distension and maternal severe anemia, and the second case of a singleton, partial molar pregnancy confirmed by chromosome analysis resulting in a diploid living baby.
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kawasaki
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kondoh
authors.affiliation: Department of Diagnostic Pathology, Kyoto University, Kyoto, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Minamiguchi
authors.affiliation: Center for Genomic Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Matsuda
authors.affiliation: Center for Genomic Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Higasa
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Fujita
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
authors.forename: Haruta
authors.initials: H
authors.lastname: Mogami
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Chigusa
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Konishi
mesh_terms: D000328:Adult; D000740:Anemia / Q000150:complications*; D004171:Diploidy; D005260:Female; D005865:Gestational Age; D006801:Humans; D006828:Hydatidiform Mole / Q000209:etiology / Q000235:genetics* / Q000473:pathology*; D050498:Live Birth; D009030:Mosaicism; D010922:Placenta Diseases / Q000209:etiology / Q000235:genetics* / Q000473:pathology*; D011225:Pre-Eclampsia; D011247:Pregnancy; D055815:Young Adult
keywords: confined placental mosaicism; maternal anemia; partial molar pregnancy; placentomegaly; pre-eclampsia