Ayati S, Vahidroodsari F, Talebian M,
Volume 69, Issue 6 (6 2011)
Abstract
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Background: Placenta accreta is a life-threatening complication after previous cesarean
delivery. The aim of this case report is to present a case of placenta percreta
with bladder involvement and subsequent maternal death.
Case
presentation: The patient was a 37-year
old who had an unwanted pregnancy due to tubectomy failure two years afterwards.
She was hospitalized at 26th and 30th week of gestation
because of gross hematuria. Sonography reported placenta previa. Cesarean section
was performed at 34th gestational week. Due to severe hemorrhage, hysterectomy with resection of some
part of the bladder was done. Died at the operating room after four hours of
severe uncontrollable hemorrhage.
Conclusion: The increasing prevalence of different forms of placenta accreta is the result
of the ever-increasing rate of cesarean deliveries. One of the strategies to
prevent this catastrophic obstetric complication is decreasing the number of cesarean
deliveries without appropriate indications.
Pourali L, Ayati S, Vahidroodsari F, Taghizadeh A, Sadat Hosseini R,
Volume 70, Issue 12 (5 2013)
Abstract
Background: In molar pregnancy, when hydatidiform changes are local and some embryonic components are observed, the term of partial mole is used. The risk of persistent trophoblastic tumor after partial mole is much lower than complete mole. In this persistent cases almost all are non metastatic. The aim of this study is to report a case of uterine rupture following incomplete molar pregnancy.
Case presentation: The patient was a 26 year old woman with obstetric history of an abortion and one molar pregnancy and no child. She was referred to emergency unit in Ghaem University Hospital, Mashhad, Iran in May 2011. She had an evacuation curettage following molar pregnancy three months before and without any follow up visit. The patient was referred to emergency unit with hemorrhagic shock. She immediately underwent laparotomy. The uterine fundal rupture was repaired and evacuation curettage performed. In post operative evaluation, she had a nine millimeter metastatic nodule in base of right Lung. As a patient in low risk stage III, she received weekly intramuscular methotrexate (40mg/m2) for six courses. In follow up visit -hCG titer was negative (<10miu/ml) at 5th week.
Conclusion: In cases of in complete molar pregnancy risk of metastasis is very low. Serial beta-hCG titer is the most accurate method for detection of persistent gestational trophoblastic disease (GTN). In neglected cases like this case preservation of ruptured uterus in GTN is possible.
Leila Pourali , Sedigheh Ayati , Fatemeh Vahidroodsari , Manizhe Javanmard , Faezeh Poursadrollah,
Volume 71, Issue 12 (March 2014)
Abstract
Background: Twin pregnancy with a fetus and a diploid complete mole is not rare, but, the cases of twin pregnancy with a partial mole are rare. Nowadays, the prevalence of these cases has been increased due to the high rate of assisted reproductive techniques in reproductive medicine. The importance of twin pregnancy with a fetus and a diploid complete mole is mainly due to systemic complications such as hypertension and maternal hemorrhage and the possibility of trophoblastic tumor following delivery. Different studies have reported some results about similar cases, but limited case reports are presented in our country. The aim of this study is to report a case with incomplete molar pregnancy concomitant with a live fetus.
Case presentation: A 21 yr old woman (G2 ab1) referred to emergency department of Ghaem University Hospital in Mashhad. She complained of scant vaginal bleeding and spotting and a sonography report of a combined molar and normal pregnancy with 15 weeks gestational aged. During hospitalization, the pregnancy complicated with hypertension and proteinuria. Termination of pregnancy was planned at 17th weeks of gestation due to severe preeclampsia. After evacuation of uterus, during follow up visits, -hCG titer raised. Metastasis evaluation was negative. Pathology reports showed patial mole. Then, three doses of methotrexate (50 mg/m2 intra muscular) was administered and finally, according to the monthly follow up, -hCG level was undetectable.
Conclusion: The rate of pregnancy complications such as hypertension, hyperthyroidism, and obstetrics hemorrhage and also the risk of Gestational Trophoblastic Neoplasm (GTN) are increasing in incomplete molar pregnancy. Therefore, early diagnosis and timely treatment of molar pregnancy is very important to reduce maternal morbidity and mortality.
