scholarly journals Term Delivery of a Complete Molar Pregnancy with a Coexistent Normal Pregnancy

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Manisha Chhetry ◽  
Aruna Pokharel ◽  
Amar Nath Chaudhary

Twin pregnancy with a complete mole and a coexistent normal fetus reaching term is a rare occurrence. We report a case of a 21-yrs G2P1L0 un-booked patient at 39 weeks who was referred for the same condition diagnosed incidentally on ultrasound scan which showed a singleton pregnancy in breech presentation with a normal placenta and a heterogeneous cystic lesion seen anteriorly, suggesting a coexistent molar pregnancy. Cesarean section was done, and a healthy male baby was delivered with a grossly normal placenta and a second placenta with grape like vesicles. Histopathology confirmed the diagnosis of complete mole and normal placenta. Postoperative period was uneventful, and the patient was kept on beta hcg follow-up to monitor progression to gestational trophoblastic neoplasia, but it normalized by 12 weeks.

Author(s):  
Aparna Rajesh ◽  
Vandana Muralidharan

Background: Hypertensive disorders of pregnancy complicate upto 10% of pregnancies worldwide, and constitute one of the greatest causes of maternal and perinatal morbidity and mortality. The goal of this study is to evaluate the serum beta hCG levels in pregnant women as a predictor of gestational hypertension.Methods: This is a prospective study done at K. S. Hegde Medical Academy during the month of November 2015 to January 2017. Serum beta hCG was estimated between 14-20 weeks of gestation in 90 women with singleton pregnancy irrespective of parity. Regular follow up of the cases were done till delivery. Results were analysed statistically.Results: Out of 90 women, 81 women were followed till term and 12 (14.8%) cases developed gestational hypertension. β HCG levels (Mean±SD) were higher (69808.66±54764.7 vs. 38126.49±97419.2; p<0.28) in subjects who developed gestational hypertension. Serum beta hCG (median >32726 mIU/ml) has a sensitivity of 75%, specificity of 72.5% and accuracy of 72.8%.Conclusions: Our study indicate an increased risk of gestational hypertension in women with elevated levels of serum beta hCG. As yet there are no practically acceptable and reliable screening tests for gestational hypertension, serum beta hCG seems to be good noninvasive early predictor for the development of gestational hypertension.


2018 ◽  
pp. bcr-2018-225545
Author(s):  
Ream Langhe ◽  
Bogdan Alexandru Muresan ◽  
Etop Akpan ◽  
Nor Azlia Abdul Wahab

The classic features of molar pregnancy are irregular vaginal bleeding, hyperemesis, enlarged uterus for gestational age and early failed pregnancy. Less common presentations include hyperthyroidism, early onset pre-eclampsia or abdominal distension due to theca lutein cysts. Here, we present a case of molar pregnancy where a woman presented to the emergency department with symptoms of acute abdomen and was treated as ruptured ectopic pregnancy. The woman underwent laparoscopy and evacuation of retained products of conception. Histological examination of uterine curettage confirmed the diagnosis of a complete hydatidiform mole. The woman was discharged home in good general condition with a plan for serial beta-human chorionic gonadotropin (beta-hCG) follow-up. Complete follow-up includes use of contraception and follow-up after beta-hCG is negative for a year.


2019 ◽  
pp. 31-34
Author(s):  
Swati Agrawal ◽  
Kiran Aggarwal ◽  
Anjali Singh ◽  
Khushbu Saha ◽  
Amrita Mishra ◽  
...  

Twin pregnancy with one live fetus and one complete mole, also known as CMCF i.e. complete molar pregnancy with coexisting live fetus is a rare entity in obstetrics. This combination is associated with increased incidences of spontaneous abortions, vaginal bleeding, prematurity, intrauterine demise, pre-eclampsia, uterine ruptures, theca lutein cysts, persistent gestational trophoblastic disease. We report a rare case of a 24-year-old patient with CMCF at 14 weeks of gestation. After confirming the diagnosis, ruling out malignancy and proper counselling, decision was taken to continue her pregnancy. However, the patient had spontaneous abortion at 15 weeks of gestation. Her serum beta Hcg has shown a decreasing trend in her follow up visits with no signs suggestive of persistent gestational trophoblastic disease.


Author(s):  
Hale Goksever Celik ◽  
Gözde Meriç Demirezen ◽  
Baki Erdem ◽  
Alev Atış Aydın ◽  
Volkan Ülker

Twin pregnancies with complete mole and a coexisting live fetus are rare obstetric conditions seen in 1 case of 22000 to 100000 pregnancies. In our case, a twin molar pregnancy was diagnosed in the first trimester by ultrasound. In a 27-year-old patient with the first pregnancy, a 12-week live fetus with a normal placenta and a twin molar pregnancy appearance were observed on a routine ultrasonographic examination of the uterine cavity. Twin molar pregnancies are reported to be terminated by live birth in the literature, but termination of pregnancy is an important option to prevent maternal morbidity since molar pregnancy may lead to complications ranging from theca lutein cysts to gestational trophoblastic neoplasia.


2021 ◽  
Vol 10 (3) ◽  
pp. 74-75
Author(s):  
Gergana Ingilizova ◽  
Sergei Slavov ◽  
Galina Yaneva

The presence of uterus didelphys is a rare pathology that does not significantly affect the chances of achieving pregnancy in the absence of other factors of infertility. We present a case of a patient with a proven abnormality - the presence of uterus didelphys - in which an IVF-ET procedure was performed due to male infertility factor. After embryo transfer of 1 embryo in each uterus, a singleton pregnancy was realized in the one uterine body. After a normal pregnancy, the patient was delivered near the due date by cesarean section without complications for the mother or fetus.This case proved the hypothesis that patients with a double uterus have a good prognosis for pregnancy. In this case, male infertility was the leading cause of infertility and after a successful in vitro procedure, a pregnancy was achieved, which ended with a successful term delivery.


Author(s):  
Muskaan Chhabra ◽  
Rekha Daver

Gestational trophoblastic disease or gestational trophoblastic neoplasia is a collective term used to describe hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumours. Since any molar pregnancy has the potential to develop into invasive mole these patients should be carefully monitored for development of malignant disease. Here we are reporting a case of invasive molar pregnancy with a single live fetus of 17 weeks gestational age. A 24 years old woman, G3P2L2 with a history of amenorrhea since approximately 5 months presented with profuse per vaginal bleeding. Ultrasound showed presence of live fetus of approximate gestational age of 17 weeks. Along with the fetus there was also presence of cystic areas with no vascularity s/o Hydatiform mole. In view of continued bleeding and severe anemia pregnancy was terminated and fetus along with vesicular tissue was expelled. On follow up Beta hcg titers showed increasing trend over the next week. Repeat USG showed extension of molar tissue into the myometrium. In view of this she was given 3 cycles of chemotherapy and eventually was discharged. She was followed up regularly with no e/o recurrence. Presence of viable fetus along with hydatiform mole is a rare occurrence in obstetric practice. After termination of pregnancy these patients should undergo follow up ultrasound and serial beta HCG titers to detect the malignant transformation. Rising beta HCG titers and invasion of myometrium on ultrasound are the ominous features suggesting malignant transformation and should be treated accordingly.


2019 ◽  
Vol 34 (1) ◽  
pp. 52-55
Author(s):  
Sabera Khatun

Hydatidiform mole (HM) is the most common form of Gestational Trophoblastic Disease (GTD). Recurrence of HM is extremely rare. Here we report the case report of a patient with five consecutive complete hydatidiform moles without any normal pregnancy. A 41-years old lady, was referred to Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with H/O repeated molar pregnancies. Her first molar pregnancy was in 2005, second in 2006, third in 2007 & fourth in 2014. All the molar pregnancies were managed by suction evacuation at her base hospital. Following evacuation of 4th molar pregnancy at base hospital, she was referred to BSMMU for subsequent management. Regular follow-up was done using molar card. All the pregnancies were complete hydatidiform mole (CHM) and were confirmed clinically and sonographically. None of the molar pregnancies needed treatment with chemotherapy. During her fifth molar pregnancy she developed shortness of breath and palpitation. Diagnostic work up in our hospital confirmed complete molar pregnancy with thyrotoxicosis, for which she received b-blocker agent and after normalization of thyrotoxicosis, she underwent total abdominal hysterectomy on 11. 10. 18. Now she is on regular follow up by serum bhCG and has no complication. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 52-55


2013 ◽  
Vol 20 (04) ◽  
pp. 638-641
Author(s):  
SHAMA CHAUDHARY ◽  
IQRA JANGDA ◽  
RUBINA HUSSAIN

Ectopic molar pregnancy is a rare occurrence. Clinical diagnosis of a molar pregnancy is difficult but histopathology is thegold standard for diagnosis. The management of ectopic molar pregnancies consists of surgically removing the conceptus, follow up &chemotherapy, if required. We are reporting a case report of a 35-year-old married, nulliparous woman, admitted in emergency with a 6-week history of amenorrhea, severe abdominal pain & an episode of fainting at home. Per abdominal examination revealed tendernessover the right iliac fossa, with guarding & rigidity. Diagnosis of ruptured ectopic pregnancy was made.Emergency laparotomy was done.Histopathological examination, showed tubal ectopic pregnancy with partial hydatidiform mole & a separate corpus luteal cyst.She wasfollowed up with serial beta hCG which became normal within 1 month. Although ectopic molar pregnancy is a rare entity but all ectopicpregnancies should be examined histologically to rule out presence of gestational trophoblastic disease to plan follow-up accordingly inorder to avoid persistent gestational trophoblastic disease which has a chance of malignant conversion.The prognosis of ectopic molarpregnancies is the same as for other forms of gestational trophoblastic disease.


2020 ◽  
Vol 8 (12) ◽  
pp. 1096-1099
Author(s):  
Fouzia El Hilali ◽  
◽  
Salahedine Achkif ◽  
Sanaa Erraghay ◽  
Mohamed Karam Saoud ◽  
...  

Twin pregnancy involving a complete mole and a normal singleton pregnancy with its own healthy trophoblast is a rare entity. The most serious complication is the progression to gestational trophoblastic disease. Reporting the case of a 38-year-old pastry, G5P4, consultant for bleeding after pregnancy of 16 weeks not followed, whose pelvic ultrasound showed the appearance of an association of a complete hydatidiform mole and a normal singleton pregnancy .The patient had a spontaneous abortion 48 hours after her hospitalization. The anathomopathologic study confirmed the diagnosis of the association of a complete mole and a normal placenta. The evolution is marked by the non-evolution towards gestational trophoblastic disease. 


Author(s):  
Norzila Ismail ◽  
Aida Maziha Zainudin ◽  
Gan Siew Hua

Abstract Objectives Level of βhCG and the presence of any uterine mass of hydatidiform mole need a careful review or monitoring in order to prevent metastasis, provide an early treatment and avoid unnecessary chemotherapy. Case presentation A 36-year old fifth gravida patient who had a missed abortion was diagnosed as having a molar pregnancy with beta human chorionic gonadotrophin (βhCG) level of 509,921 IU/L. Her lung field was clear and she underwent suction and curettage (S & C) procedure. However, after six weeks, AA presented to the emergency department with a massive bleeding, although her βhCG level had decreased to 65,770 IU/L. A trans-abdominal ultrasound indicated the presence of an intra-uterine mass (3.0 × 4.4 cm). Nevertheless, her βhCG continued to show a declining trend (8,426 IU/L). AA was advised to undergo a chemotherapy but she refused, citing preference for alternative medicine like herbs instead. She opted for an “at own risk” (AOR) discharge with scheduled follow up. Subsequently, her condition improved with her βhCG showing a downward trend. Surprisingly, at six months post S & C, her βhCG ameliorated to 0 IU/L with no mass detected by ultrasound. Conclusions Brucea javanica fruits, Pereskia bleo and Annona muricata leaves can potentially be useful alternatives to chemotherapy and need further studies.


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