Abstract
Breus' mole, a massive hematoma developing directly beneath the chorion on the fetal side of the placenta is a rare disease. With this disease, it is said that a massive hematoma develops in the placenta, that the fetus-placenta circulation is impaired, that the incidence of intrauterine growth retardation (IUGR) and intrauterine fetal death is high, and that fetal prognosis is often poor. This time we have encountered a case complicated by IUGR and gestosis, which was suspected of having Breus' mole before childbirth and gave birth to a live baby. A 38-year-old primigravida had been under observation at the out-patient clinic of this hospital since her first trimester. Examination at 32 weeks of gestation revealed hypertension, proteinuria and edema, so diagnosis of gestosis was made. With hematoma found in the placenta at 33 weeks and 5 days of gestation, she was admitted to this hospital. The hematoma on admission measured 41.6 mm in major diameter and 38.4mm in thickness. It grew slowly to 48.6mm in major diameter, 43.4mm in thickness at 35 weeks and 1 day and 100.6mm in major diameter, 100.4mm in thickness at 36 weeks and 2 days when fetal asphyxia appeared. Emergency cesarean section was then performed for delivery (baby boy weighing 1730g, Apger score 8-10-10). The placenta showed clots and infarct layers, which led to the diagnosis of Breus' mole.
