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J Assist Reprod Genet ; 37(9): 2273-2277, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32592075

RESUMEN

Molar pregnancies are benign trophoblastic diseases associated with a risk of malignant transformation. If aetiology remains mostly unknown, the risk of recurrent molar pregnancy is around 1.5% after one molar pregnancy and around 25% after 2 molar pregnancies. In the later situation, genetic mutations have been described, increasing hugely this risk. In case of mutations, probability to obtain a normal pregnancy is estimated around 1.8%. We report the case of a Caucasian 30-year-old woman whose previous five spontaneous pregnancies had a negative outcome: a spontaneous miscarriage and then 4 complete hydatidiform moles. Genetic testing revealed that the patient carried two heterozygous mutations in the NLRP7 gene (c.2982-2A > G and Y318CfsX7). According to this, counselling was conducted to advocate for oocyte donation in order to obtain a normal pregnancy. This technique enabled a complication-free, singleton pregnancy that resulted in a healthy term live birth of a 2900 g female. Few months after delivery, the patient presented a new complete hydatidiform mole. Women presented with mutations in the NLRP7, KHDC3L or PADI6 genes are unlikely to obtain normal pregnancies, with a major risk of reproductive failure. In such a context, oocyte donation may be the best option. Only 4 normal pregnancies and deliveries have been published in this situation through this technique to our knowledge.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/genética , Mola Hidatiforme/genética , Recurrencia Local de Neoplasia/genética , Complicaciones Neoplásicas del Embarazo/genética , Aborto Espontáneo/genética , Aborto Espontáneo/fisiopatología , Adulto , Femenino , Humanos , Mola Hidatiforme/patología , Mutación/genética , Recurrencia Local de Neoplasia/patología , Neoplasias/genética , Neoplasias/patología , Donación de Oocito/métodos , Embarazo , Complicaciones Neoplásicas del Embarazo/patología
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