Complete hydatidiform mole with a coexistent live fetus in a twin pregnancy

Abstract

Background: The reported incidence of hydatidiform mole with coexisting pregnancy is one in 22 000–100 000 pregnancies, most of them being complete hydatidiform moles (CHM) with a fetus; however, the reported prevalence, for a partial mole with a coexisting fetus is 0.005–0.01% of pregnancies. Case report: This is a case report of a hydatidiform mole with a coexistent live fetus diagnosed at 18 weeks. After thorough counselling, the pregnancy was continued as per the patient’s desire. The pregnancy was closely monitored with serial Serum β hCG, and ultrasound for fetal growth. An emergency caesarean delivery was done at 30 weeks, due to bleeding per vaginam. A live baby was delivered with near normal Apgar score. The placenta with molar tissue was sent for histopathological examination. The histopathology revealed a complete mole with normal placenta. Her serum β hCG reached normal levels after delivery, and she is now on surveillance. Though the general trend is to terminate pregnancy in twins with coexistent mole in anticipation of complications, under close surveillance, optimal outcomes can be achieved. Conclusion: The option of continuing a twin pregnancy with a complete mole is acceptable. However a close surveillance is required to detect potential early signs of complications. Histopathological examination is essential in distinguishing between partial and complete mole and/or with ancillary studies.

Keywords

• complete hydatidiform mole
• twin pregnancy
• partial mole
• trophoblast
• hydatidiform mole