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Re: Partial Mole with Viable Pregnancy?From: art fougner, md (evsono@pipeline.com)Mon Nov 10 17:49:53 1997
At Mon, 10 Nov 1997, rbraun@iupui.edu wrote: > >Many of these will develop SEVERE toxemia, some as early as 16-20 weeks. I >am not aware of any reports of successful continuation to term. They may >be out there I ahven't searched. I would be very nervous about this if it >is a significant part Mole. If the sonographer is seeing one or two small >cysts and calling it a partial mole, it might be another thing. Look at >the placenta yourself or with your Perinatologist. > >R. Daniel Braun, MD FACOG > >On Mon, 10 Nov 1997, Michael J. Wolpmann, M.D. wrote: > >> Recently asked this question: >> 32 Y/O with partial mole on U/S at 16 weeks, viable appearing infant >> with no 'visible' anomalies. >> Can she take it to term? >> >> Think this might be possible with twin gestation but have never heard of >> it. Risk of metastatic disease, other sequela would seem to make this a >> bad idea. >> Any thoughts on this? Thanks. >> >> Michael >> >> -- >> michael j. wolpmann, md >> here are some more - Title Clinical features of multiple conception with partial or complete molar pregnancy and coexisting fetuses. Author Steller MA; Genest DR; Bernstein MR; Lage JM; Goldstein DP; Berkowitz RS Address New England Trophoblastic Disease Center, Brigham and Women's Hospital, Boston, Massachusetts 02115. Source J Reprod Med, 39(3):147-54 1994 Mar Abstract The estimated incidence of twin pregnancy consisting of hydatidiform mole and a coexisting fetus is 1 per 22,000-100,000 pregnancies. Since 1965, nine patients with this entity have been treated at the New England Trophoblastic Disease Center (NETDC), Boston. One patient had a partial hydatidiform mole coexisting with a normal placenta and fetus. The other eight patients had twin pregnancies with a complete hydatidiform mole (CHM) and coexisting fetus. We compared the clinical outcomes in these 8 patients and 14 additional published case reports of multiple gestations composed of CHM and coexisting fetuses with a group of 71 patients with singleton CHM treated at NETDC. Twelve of the 22 patients (55%) with CHM and coexisting fetuses developed persistent gestational trophoblastic tumor, requiring chemotherapy. Five of these patients developed metastases requiring multiple cycles of chemotherapy to achieve remission. The presenting symptoms of multiple conception with CHM and coexisting fetuses were similar to those in patients with a singleton conception and complete mole. However, as compared to singleton CHM, patients having a multiple conception with CHM and coexisting fetuses were diagnosed at a later gestational age, had higher preevacuation beta-human chorionic gonadotropin levels and had a greater propensity to develop persistent tumor. These data indicate that patients with multiple conceptions consisting of CHM and coexisting fetuses are at high risk of developing persistent gestational trophoblastic tumor. Title Favorable outcome in a twin pregnancy with complete hydatidiform mole and coexisting fetus. Author Eblen AC; Richards DS Address Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, USA. Source J Matern Fetal Med, 5(6):345-7 1996 Nov-Dec Abstract A complete hydatidiform mole coexisting with a normal fetus decreased in size in the second half of pregnancy, and the patient delivered a healthy infant at term. This and other reported cases suggest that the presence or absence of symptoms such as preeclampsia or bleeding predicts pregnancy outcome. art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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