Incidental diagnosis of sad fetus syndrome in triplets
An unusual presentation of gestational trophoblastic disease is twin molar pregnancy, rarest in triplets with differentials being partial/complete mole, placental mesenchymal dysplasia (PMD), placental cysts or chorioangioma each with different complications. Counselling to continue pregnancy depend...
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| creator | Rajasekaran, Keerthana Dadhwal, Vatsla Jassim, Mohamed |
| description | An unusual presentation of gestational trophoblastic disease is twin molar pregnancy, rarest in triplets with differentials being partial/complete mole, placental mesenchymal dysplasia (PMD), placental cysts or chorioangioma each with different complications. Counselling to continue pregnancy depends on diagnosis. A 37-year-old G
P
L
, donor oocyte In vitro fertlisation (IVF) twin pregnancy was referred at 24 weeks with cystic areas in placenta. Probability of twin partial mole or PMD was assessed. The scan of fetuses showed normal growth, no structural anomalies. Biochemical markers showed high maternal beta human chorionic gonadotropin (β-hCG). Amniocentesis of molar fetus revealed normal karyotype. Likely diagnosis made as twin partial mole. The patient delivered by caesarean section at 28
weeks due to preterm labour. Twins, a male and a female baby, were delivered with three placentas, two normal and the third with molar changes and no fetal parts. Diagnosis was revised as triplet with partial mole, which was confirmed on histopathology. Serial monitoring of β-hCG became undetectable by eighth week. The male baby died on day 4. The mother and the female baby were discharged. |
| doi_str_mv | 10.1136/bcr-2020-238977 |
| format | Article |
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P
L
, donor oocyte In vitro fertlisation (IVF) twin pregnancy was referred at 24 weeks with cystic areas in placenta. Probability of twin partial mole or PMD was assessed. The scan of fetuses showed normal growth, no structural anomalies. Biochemical markers showed high maternal beta human chorionic gonadotropin (β-hCG). Amniocentesis of molar fetus revealed normal karyotype. Likely diagnosis made as twin partial mole. The patient delivered by caesarean section at 28
weeks due to preterm labour. Twins, a male and a female baby, were delivered with three placentas, two normal and the third with molar changes and no fetal parts. Diagnosis was revised as triplet with partial mole, which was confirmed on histopathology. Serial monitoring of β-hCG became undetectable by eighth week. The male baby died on day 4. The mother and the female baby were discharged.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2020-238977</identifier><identifier>PMID: 33541990</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Amniocentesis ; Case Report ; Case reports ; Cesarean Section ; Chemotherapy ; Cysts ; Female ; Fertilization in Vitro ; Fetus - pathology ; Fetuses ; Histopathology ; Humans ; Hydatidiform Mole - diagnosis ; Hydatidiform Mole - pathology ; Medical diagnosis ; Obstetrics ; Placenta ; Placenta - pathology ; Postpartum period ; Preeclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Triplet ; Thyroid gland ; Twins ; Ultrasonic imaging ; Ultrasonography, Prenatal</subject><ispartof>BMJ case reports, 2021-02, Vol.14 (2), p.e238977</ispartof><rights>BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2021 BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c375t-27d1ef4b6d1a0f89a80e62d1af9af3ab87280a276c3addd6bf9d4bd477b29b333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868267/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868267/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33541990$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rajasekaran, Keerthana</creatorcontrib><creatorcontrib>Dadhwal, Vatsla</creatorcontrib><creatorcontrib>Jassim, Mohamed</creatorcontrib><title>Incidental diagnosis of sad fetus syndrome in triplets</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>An unusual presentation of gestational trophoblastic disease is twin molar pregnancy, rarest in triplets with differentials being partial/complete mole, placental mesenchymal dysplasia (PMD), placental cysts or chorioangioma each with different complications. Counselling to continue pregnancy depends on diagnosis. A 37-year-old G
P
L
, donor oocyte In vitro fertlisation (IVF) twin pregnancy was referred at 24 weeks with cystic areas in placenta. Probability of twin partial mole or PMD was assessed. The scan of fetuses showed normal growth, no structural anomalies. Biochemical markers showed high maternal beta human chorionic gonadotropin (β-hCG). Amniocentesis of molar fetus revealed normal karyotype. Likely diagnosis made as twin partial mole. The patient delivered by caesarean section at 28
weeks due to preterm labour. Twins, a male and a female baby, were delivered with three placentas, two normal and the third with molar changes and no fetal parts. Diagnosis was revised as triplet with partial mole, which was confirmed on histopathology. Serial monitoring of β-hCG became undetectable by eighth week. The male baby died on day 4. The mother and the female baby were discharged.</description><subject>Adult</subject><subject>Amniocentesis</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Cesarean Section</subject><subject>Chemotherapy</subject><subject>Cysts</subject><subject>Female</subject><subject>Fertilization in Vitro</subject><subject>Fetus - pathology</subject><subject>Fetuses</subject><subject>Histopathology</subject><subject>Humans</subject><subject>Hydatidiform Mole - diagnosis</subject><subject>Hydatidiform Mole - pathology</subject><subject>Medical diagnosis</subject><subject>Obstetrics</subject><subject>Placenta</subject><subject>Placenta - pathology</subject><subject>Postpartum period</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy, Triplet</subject><subject>Thyroid gland</subject><subject>Twins</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Prenatal</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkc1LwzAYh4MobsydvUnBi5e6fLRJehFk-DEYeFHwFpImmRltM5NW2H9vxuZQc0le3ic_3pcHgEsEbxEidKbqkGOIYY4Jrxg7AWPESpazCr6f_nqPwDTGNUyHoIIX5ByMCCkLVFVwDOiiq502XS-bTDu56nx0MfM2i1Jn1vRDzOK208G3JnNd1ge3aUwfL8CZlU0008M9AW-PD6_z53z58rSY3y_zmrCyzzHTyNhCUY0ktLySHBqKU2EraYlUnGEOJWa0JlJrTZWtdKF0wZjClSKETMDdPnczqNboOg0aZCM2wbUybIWXTvztdO5DrPyXYJxyTFkKuDkEBP85mNiL1sXaNI3sjB-iwAVnqOSshAm9_oeu_RC6tJ7AJcIMY0RRomZ7qg4-xmDscRgExU6LSFrETovYa0k_rn7vcOR_JJBvFsGJaQ</recordid><startdate>20210204</startdate><enddate>20210204</enddate><creator>Rajasekaran, Keerthana</creator><creator>Dadhwal, Vatsla</creator><creator>Jassim, Mohamed</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210204</creationdate><title>Incidental diagnosis of sad fetus syndrome in triplets</title><author>Rajasekaran, Keerthana ; Dadhwal, Vatsla ; Jassim, Mohamed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-27d1ef4b6d1a0f89a80e62d1af9af3ab87280a276c3addd6bf9d4bd477b29b333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Amniocentesis</topic><topic>Case Report</topic><topic>Case reports</topic><topic>Cesarean Section</topic><topic>Chemotherapy</topic><topic>Cysts</topic><topic>Female</topic><topic>Fertilization in Vitro</topic><topic>Fetus - pathology</topic><topic>Fetuses</topic><topic>Histopathology</topic><topic>Humans</topic><topic>Hydatidiform Mole - diagnosis</topic><topic>Hydatidiform Mole - pathology</topic><topic>Medical diagnosis</topic><topic>Obstetrics</topic><topic>Placenta</topic><topic>Placenta - pathology</topic><topic>Postpartum period</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy, Triplet</topic><topic>Thyroid gland</topic><topic>Twins</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Prenatal</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rajasekaran, Keerthana</creatorcontrib><creatorcontrib>Dadhwal, Vatsla</creatorcontrib><creatorcontrib>Jassim, Mohamed</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rajasekaran, Keerthana</au><au>Dadhwal, Vatsla</au><au>Jassim, Mohamed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidental diagnosis of sad fetus syndrome in triplets</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2021-02-04</date><risdate>2021</risdate><volume>14</volume><issue>2</issue><spage>e238977</spage><pages>e238977-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>An unusual presentation of gestational trophoblastic disease is twin molar pregnancy, rarest in triplets with differentials being partial/complete mole, placental mesenchymal dysplasia (PMD), placental cysts or chorioangioma each with different complications. Counselling to continue pregnancy depends on diagnosis. A 37-year-old G
P
L
, donor oocyte In vitro fertlisation (IVF) twin pregnancy was referred at 24 weeks with cystic areas in placenta. Probability of twin partial mole or PMD was assessed. The scan of fetuses showed normal growth, no structural anomalies. Biochemical markers showed high maternal beta human chorionic gonadotropin (β-hCG). Amniocentesis of molar fetus revealed normal karyotype. Likely diagnosis made as twin partial mole. The patient delivered by caesarean section at 28
weeks due to preterm labour. Twins, a male and a female baby, were delivered with three placentas, two normal and the third with molar changes and no fetal parts. Diagnosis was revised as triplet with partial mole, which was confirmed on histopathology. Serial monitoring of β-hCG became undetectable by eighth week. The male baby died on day 4. The mother and the female baby were discharged.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>33541990</pmid><doi>10.1136/bcr-2020-238977</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adult Amniocentesis Case Report Case reports Cesarean Section Chemotherapy Cysts Female Fertilization in Vitro Fetus - pathology Fetuses Histopathology Humans Hydatidiform Mole - diagnosis Hydatidiform Mole - pathology Medical diagnosis Obstetrics Placenta Placenta - pathology Postpartum period Preeclampsia Pregnancy Pregnancy Outcome Pregnancy, Triplet Thyroid gland Twins Ultrasonic imaging Ultrasonography, Prenatal |
| title | Incidental diagnosis of sad fetus syndrome in triplets |
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