Intraplacental choriocarcinoma and fetomaternal haemorrhage and maternal disseminated intravascular coagulopathy in a term pregnancy: A case report.
Choriocarcinoma
Disseminated intravascular coagulopathy
Fetomateral haemorrhage
Neonatal anaemia
Journal
Case reports in women's health
ISSN: 2214-9112
Titre abrégé: Case Rep Womens Health
Pays: Netherlands
ID NLM: 101682122
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
13
04
2020
revised:
03
05
2020
accepted:
05
05
2020
entrez:
19
5
2020
pubmed:
19
5
2020
medline:
19
5
2020
Statut:
epublish
Résumé
Intraplacental choriocarcinoma (ICC) is a rare form of gestational trophoblastic disease that has been documented as complicating near-term pregnancies with massive fetomaternal haemorrhage (FMH), intrauterine fetal demise, neonatal anaemia, and disseminated disease of both mother and child. A 31-year-old woman at 38 weeks of gestation underwent caesarean section due to reduced fetal movements. The caesarean section was complicated by disseminated intravascular coagulopathy (DIC). Massive FMH and choriocarcinoma were diagnosed after delivery. Review of the literature demonstrated this to be the first published case of DIC associated with choriocarcinoma, a rare complication. The literature suggests post-partum serial measurement of beta human chorionic gonadotropin (β-HCG) in women with unexplained massive FMH. This case demonstrates the potential to reduce morbidity and mortality by earlier diagnosis of choriocarcinoma by means of surveillance of serial β-HCG levels in patient and child. The patient underwent 4-agent chemotherapy after methotrexate alone failed to achieve remission. β-HCG levels were undetectable at the time of publishing this case report and the child is healthy with no complications.
Sections du résumé
BACKGROUND
BACKGROUND
Intraplacental choriocarcinoma (ICC) is a rare form of gestational trophoblastic disease that has been documented as complicating near-term pregnancies with massive fetomaternal haemorrhage (FMH), intrauterine fetal demise, neonatal anaemia, and disseminated disease of both mother and child.
CASE
METHODS
A 31-year-old woman at 38 weeks of gestation underwent caesarean section due to reduced fetal movements. The caesarean section was complicated by disseminated intravascular coagulopathy (DIC). Massive FMH and choriocarcinoma were diagnosed after delivery.
DISCUSSION
CONCLUSIONS
Review of the literature demonstrated this to be the first published case of DIC associated with choriocarcinoma, a rare complication. The literature suggests post-partum serial measurement of beta human chorionic gonadotropin (β-HCG) in women with unexplained massive FMH. This case demonstrates the potential to reduce morbidity and mortality by earlier diagnosis of choriocarcinoma by means of surveillance of serial β-HCG levels in patient and child.
OUTCOME
RESULTS
The patient underwent 4-agent chemotherapy after methotrexate alone failed to achieve remission. β-HCG levels were undetectable at the time of publishing this case report and the child is healthy with no complications.
Identifiants
pubmed: 32420044
doi: 10.1016/j.crwh.2020.e00216
pii: S2214-9112(20)30046-1
pii: e00216
pmc: PMC7218156
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e00216Informations de copyright
© 2020 Published by Elsevier B.V.
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