Department of Gynecology and Obstetrics II, Hassan II University Hospital Center, Faculty of Medicine, Pharmacy and Dental Medicine, Sidi
Mohamed Ben Abdellah University, Fez, Morocco
Partial hydatidiform mole is an uncommon form of gestational trophoblastic disease and is usually diagnosed during the first trimester. Persistence into the second trimester with fetal development is rare and may present as late miscarriage or fetal demise, creating diagnostic and therapeutic challenges. We report two anonymized cases managed at Hassan II University Hospital Center in Fez, Morocco. The first patient was a 34-year-old gravida 4 para 2 referred at approximately 17 weeks of gestation for suspected trophoblastic disease after recurrent metrorrhagia, exaggerated pregnancy symptoms, severe anemia, markedly elevated beta- hCG and ultrasound findings of a live fetus with a thick heterogeneous multicystic placenta and bilateral theca lutein cysts. During admission, she expelled a living male fetus with the placenta. Post-expulsion follow-up was marked by an initial beta-hCG decrease followed by persistent re-elevation. Control ultrasound showed an empty uterine cavity in a globular enlarged adenomyotic uterus and persistent bilateral theca lutein cysts reaching 15 cm after two months. Hysteroscopy revealed placental debris, prompting aspiration for histopathological proof because the initial placental pathology had not confirmed a molar lesion. The second specimen was also negative for molar changes, but beta-hCG continued to rise. Cerebral, thoracic, abdominal and pelvic computed tomography did not identify another lesion likely to secrete beta-hCG. The patient was therefore managed as postmolar gestational trophoblastic neoplasia and received six cycles of methotrexate. The second patient was a 25-year-old primigravida followed at 21 weeks of gestation after ultrasound suspicion of partial molar pregnancy, with a live fetus, suspected cardiac malformations, a thick vacuolated placenta, large theca lutein cysts and beta-hCG greater than 225,000 IU/L. She subsequently delivered a stillborn female fetus by vaginal delivery, followed by progressive decline of beta-hCG under weekly surveillance. These cases emphasize that partial molar pregnancy should be considered when second-trimester pregnancy loss is associated with cystic placental changes, markedly elevated beta-hCG and theca lutein cysts. They also highlight the importance of histopathological confirmation, serial beta-hCG monitoring and multidisciplinary follow-up to detect retained trophoblastic tissue or postmolar gestational trophoblastic neoplasia.
Keywords: Partial Hydatidiform Mole; Molar Pregnancy; Gestational Trophoblastic Disease; Gestational Trophoblastic Neoplasia; Late Miscarriage; Second-Trimester Pregnancy Loss; Beta-hCG; Theca Lutein Cysts
Benchaaboune Kenza., et al. “Second-Trimester Pregnancy Loss Associated with Suspected Partial Hydatidiform Mole: Two Case Reports from a Moroccan Tertiary Center”. EC Gynaecology 15.8 (2026): 01-07.
© 2026 Benchaaboune Kenza., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Open Access by ECronicon is
licensed under a Creative Commons Attribution
4.0 International License
Based on a work at www.ecronicon.net
