Ginecol Obstet Mex. 2017 diciembre;85(12):853-861. DOI: https://doi.org/10.24245/gom.v85i12.1583

Resumen

ANTECEDENTES: el embarazo molar coexistente con un feto vivo es una rareza y un reto médico porque se asocia con complicaciones maternas graves que ponen en riesgo la vida de la madre y su hijo.

CASOS CLÍNICOS: Caso 1: paciente con embarazo gemelar, con mola completa coexistente con feto vivo y terminación del embarazo por cesárea a las 33 semanas, nació una niña viva, de 1530 g, que sobrevivió sin complicaciones. Caso 2: paciente con mola parcial, embarazo complicado con preeclampsia severa, hipertiroidismo y placenta previa. La gestación se interrumpió por cesárea a las 24 semanas, el feto pesó 625 g y no sobrevivió a las maniobras de reanimación neonatal.

CONCLUSIONES: en las pacientes con embarazo molar coexistente con feto vivo deben valorarse las complicaciones presentes o potenciales que condicionan el riesgo de muerte materna y perinatal. La atención médica debe ser multidisciplinaria y siempre de común acuerdo con los padres.

PALABRAS CLAVE: mola hidatiforme completa, mola hidatiforme parcial, feto vivo, embarazo gemelar.

Hydatidiform mole coexisting with a live fetus greater than 20 weeks of gestation: Two cases report.

Ginecol Obstet Mex. 2017 Dec;85(12):853-861. DOI: https://doi.org/10.24245/gom.v85i12.1583

Abstract

BACKGROUND: Coexistance of molar pregnancy and alive fetus is an extremely rare condition but a medical challenge when it is present. Several maternal medical complications are associated with these pregnancies including both mother and fetus life-threatening conditions.

CLINICAL CASE: Two cases of molar pregnancies are presented in this paper. First was a twin pregnancy with a complete hydatidiform coexisting with a live fetus and cesarean birth at 33 weeks of gestation of a live female weighing 1,530 g. that survived without complications. Second case was an incomplete mole complicated with severe pre-eclampsia, hypertiroidism, and placenta previa; pregnancy was interrupted at 24 weeks of gestation and a fetus weighing 625 g was extracted by cesarean section, the neonate did not survive.

CONCLUSION: In the presence of molar pregnancy coexisting with a live viable fetus, the present or potential complications that determine the risk of maternal and perinatal death, must be carefully assessed. A third-level perinatal facilities must be available for this kind of pregnancy complication.

KEYWORDS: Complete hydatidiform mole; Incomplete hydatidiform mole; Live fetus; Multiple gestation