June 30th, 2022

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Eclampsia Complicating Hydatidiform Molar Pregnancy with a Coexisting, Viable Fetus: A Case Report
Authors:  Patrick S. Ramsey, M.D., Jo T. Van Winter, M.D., Thomas A. Gaffey, M.D., and Kirk D. Ramin, M.D.
BACKGROUND: Eclampsia is a rare and serious complication of pregnancy. The occurrence of preeclampsia prior to the 20th week of gestation has been associated with concurrent hydatidiform molar pregnancy. We present a case of eclampsia complicating a partial molar pregnancy associated with a viable fetus.

CASE: A 22-year-old white woman, gravida 1, para 0, at 14 weeks# gestation, presented with an excruciating headache associated with hypertension, proteinuria and a viable intrauterine fetus with gastroschisis. Subsequently the patient had a generalized tonic-clonic seizure which resolved with magnesium sulfate therapy. Markedly elevated quantitative human chorionic gonadotropin and a moderately thickened placenta were the sole clinical features suggestive of a molar gestation. Dilation and evacuation was performed revealing unremarkable products of conception. Pathologic and cytogenetic analyses revealed a triploid fetus (69,XXX) consistent with partial molar pregnancy.

CONCLUSION: Development of preeclampsia/eclampsia prior to 20 weeks of gestation should prompt a clinical evaluation to exclude the possibility of an underlying hydatidiform molar pregnancy. (J Reprod Med 1998;43:456-458)
Keywords:  eclampsia; hydatidiform mole; placenta
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