Enfermedad Trofoblástica Gestacional: Mola Hidatiforme Parcial

Abstract

Gestational trophoblastic disease, included a focal hydatidiform changes are characterized by hydropic degeneration of chorionic villi and trophoblastic hyperplasia, comprising: hydatidiform mole (partial and complete), invasive mole, gestational trophoblastic neoplastic, placental site trophoblastic tumor and choriocarcinoma. Dropsy histologically diffuse stromal edema characteristically avascular chorionic villus, whose diameter ranges from 0.1 to 3 cm is evident; thus acquiring the morphology of bands and clusters of vesicles that give the appearance of "Bunch of Grapes", are harmless while other vascular placental villi with fetal circulation. In the 75% of molar pregnancies are complete, with androgenetic diploid chromosome complement; the remaining 25% belongs to the partial hydatidiform mole with triploid chromosome complement regular or sporadic cases. So in the 45% of these women with a partial mole arrived at 28 weeks of gestation, of which 70% lived on. Therefore it is essential to the realization of cytogenetic study and high resolution ultrasonography. The present clinical case is a female patient 26 years old, FUM: July 5, 2015 (unreliable), gestational age 14 weeks echo made the September 28, 2015, which reports: Pregnancy 14 weeks + single fetus alive + partial placental hydropic degeneration (partial mole), In hospitalization she received two doses of Misoprostol is imposed to perform curettage, but on the evidence of a live fetus and apparently normal amniocentesis decided to perform more genetic study, with a genetic result of 46XX. At 29 weeks gestation, is again entering in hospital with diagnostic of initial labor of part + low amniotic liquid + early rupture of membranes 36 hours of evolution, so it was decided to terminate the pregnancy by cesarean, we got a RN active, female, minute Apgar 8 and five minutes of born 9, weight: 1105 g, size: 35.5 cm, head circumference: 25.5 cm, and a posterior fundic placenta with characteristics of partial mole, tubal ligation is performed. Monitoring BHCG quantitative is done in progressive decline and good prognosis in the future.