PARTIAL MOLAR PREGNANCY AT 8 MONTHS WITH A DIZYGOTIC FETUS MISTAKENLY DIAGNOSED AS A RETROPLACENTAL HEMATOMA: A CASE REPORT

Dr. CHIMI Hanae*, Dr. LOUKILI Najoua, Dr. Maakoul Rachid, Dr. LAABOUB Khaoula, Pr. BARGACH Samir

ABSTRACT

Introduction: Partial hydatidiform mole (PHM) is a rare type of gestational trophoblastic disease with an
incidence of 3 per 1000 pregnancies. It involves localized trophoblastic hyperplasia and degeneration of chorionic
villi, sometimes with identifiable fetal tissue. The genetic cause is typically a triploid conception due to the
fertilization of an ovum by two spermatozoa or a duplicated spermatozoon. PHM is very rare when a living fetus
with a normal karyotype is present, occurring in 0.005 to 0.01% of pregnancies, and is difficult to diagnose,
particularly in the absence of clear clinical signs. Case presentation: A 40-year-old woman, with no notable
medical history and an unmonitored pregnancy, was admitted for severe preeclampsia, positive bleeding, and
contractions and other symptoms. The ultrasound showed a placenta with multiple anechoic areas, revealing a nonviable
pregnancy with and a diagnosis of HELLP syndrome with renal failure. An emergency cesarean was
performed, resulting in the delivery of a stillborn male fetus and the discovery of a partial mole. Post-operatively,
the patient received methotrexate and folinic acid chemotherapy until the beta-HCG levels normalized and was
monitored monthly for six months, showing favorable progress. Discussion: Conclusion: Partial mole with a
diploid fetus is a very rare condition that can be challenging to diagnose due to often lacking clinical evidence.
Early suspicion and careful diagnosis are crucial for effective management, with ultrasound being a key diagnostic
tool and amniocentesis used for confirmation. In the absence of significant fetal abnormalities and manageable
maternal complications, continuing the pregnancy is recommended.

Keywords: Partial mole pregnancy; diploid fetus; cesarean section; methotrexate.