[Partial hydatidiform mmole at the 17th week of pregnancy]

A 36-year-old woman, at the 17th week +5 days gestational age, who was already admitted to the nephrology department for gestational hypertension, proteinuria and legs oedema, was admitted to our Institute. About three weeks before her admission to the nephrology dept., the patient presented heart palpitations and exertional dyspnoea related to the first evidence of the legs oedema, weight gain (about 5 kg during only one month) and normal blood pressure values. During the following days, an antihypertensive therapy was made, but hypertensive crisis and strong headache were also persistent. Vulvar oedema was observed, the uterus was moderately contracted and its dimensions were similar to an uterus at the 21st week; beta-hCG serum values were more than 500,000 IU/lt. An echography confirmed the diagnostic suspicion of hydatidiform the presence of a fetus developed as much as the gestational time. beta-hCG serum values increased to 1,200,000 IU/lt; the molar abortion induction was made thru prostaglandins: fetal extrusion occurred after three hours. The placenta was instrumentally extracted and it showed evident hydatidiform moles a uterine curettage. Patient temperature was very high (39 degrees C) in the immediate postoperative period and three hematologic pockets were transfused. After a week, we made a second elective uterine curettage with the extraction of a little quantity of gestational material; the patient was still hospitalised for ten days: during this time there was a progressive decrease of the beta-hCG serum values (last value at discharge: 7,200 IU/lt). The patient had also positive beta-hCG serum values after about one year.