PMD Initially Diagnosed as Partial Mole.

A 23-year-old third gravida reported to the Department of Obstetrics and Gynecology, Govt. Medical College, Calicut, Kerala, as a referred case of suspected partial mole. She was at 34 weeks of gestation and had regular antenatal checkups from a private hospital. She had no previous medical/surgical problems. Her previous deliveries were normal, but the second baby died on the 15th postnatal day due to congenital heart disease. On examination, the vitals were stable and systems were within normal limits. Uterine size corresponded to 32 weeks of gestation with cephalic presentation and good fetal heart sounds. All the investigations were normal, except for an ultrasound taken at 21 weeks 4 days of gestation showing a live fetus of gestational age 20 weeks ? 5 days with the placenta showing multiple anechoic areas. The pending diagnosis was hydropic degeneration of placenta, partial mole or extension of fibrin deposition. A repeat ultrasound 2 weeks later showed an active fetus with the placenta showing increased thickness with multiple sonolucent areas of 2–5 mm with the possibility of a partial mole and/or PMD. Serial USGs showed a fetus with no detectable anomalies and placental findings consistent with a partial mole. The patient was counseled regarding the possible diagnosis and the pregnancy was continued with her consent as she had no complication and the fetus had no other problems. At 38 weeks of gestation, labor was induced with prostaglandin E2. She had a normal delivery and gave birth to a 2.18-kg female baby with Apgar ’19. The baby had no external anomalies, but the placenta showed remarkably dilated vessels (Figs. 1, 2). The placenta was sent for histopathologic examination. The mother and baby were well and were discharged on the third postnatal day. They were advised to review with b-hCG and fetal karyotyping after 6 weeks. Histopathology examination of the placenta showed hydropic villi with thick muscular vessels separated by edema fluid, myxoid Sreedevi N. S., Professor and Head of the Department D’Couth S., Senior Lecturer Murali V., Post-graduate Student Vinayachandran S., Associate Professor Pavithran M., Assistant Professor Department of Obstetrics and Gynecology, Institute of Maternal and Child Health, Medical College, Calicut, Kerala, India