How to Deal with a Rare Entity: The Coexistence of a Complete Mole and a Healthy Egg in a Twin Pregnancy?

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.

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GROSSESSE GEMELLAIRE ASSOCIANT UNE MOLE COMPLETE ET UNE GROSSESSE SINGLETON NORMALE: A PROPOS DUN CAS

International Journal of Advanced Research ◽

10.21474/ijar01/12258 ◽

2020 ◽

Vol 8 (12) ◽

pp. 1096-1099

Author(s):

Fouzia El Hilali ◽

◽

Salahedine Achkif ◽

Sanaa Erraghay ◽

Mohamed Karam Saoud ◽

...

Keyword(s):

Twin Pregnancy ◽

Hydatidiform Mole ◽

Gestational Trophoblastic Disease ◽

Rare Entity ◽

Pelvic Ultrasound ◽

Complete Hydatidiform Mole ◽

Singleton Pregnancy ◽

Trophoblastic Disease ◽

Complete Mole ◽

Normal Placenta

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. ï»¿

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Complete mole in a dichorionic twin pregnancy after intracytoplasmic sperm injection

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1590/s0100-72032013000100008 ◽

2013 ◽

Vol 35 (1) ◽

pp. 39-43 ◽

Cited By ~ 7

Author(s):

Tiago José Santos de Matos Ferraz ◽

Carla Maria Magno Bartosch ◽

Carla Maria Almeida Ramalho ◽

Filipa Abreu Gomes de Carvalho ◽

Berta Cecília Campos Lima de Carvalho ◽

...

Keyword(s):

Intracytoplasmic Sperm Injection ◽

Twin Pregnancy ◽

Complete Mole

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A Case of Sirenomelia Associated with Hypoplastic Left Heart with a Healthy Co-Twin: A Rare Entity

Case Reports in Pediatrics ◽

10.1155/2018/9361745 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Houda Nasser Al Yaqoubi ◽

Muna Mubarak Al Badi ◽

Farida Mohsin Ambu Saidi ◽

Nasser Shaikhan Taaeeb Al Shafouri

Keyword(s):

Hypoplastic Left Heart Syndrome ◽

Twin Pregnancy ◽

Monozygotic Twins ◽

Monozygotic Twin ◽

Rare Entity ◽

Left Heart ◽

Hypoplastic Left Heart ◽

Dizygotic Twins ◽

Left Heart Syndrome ◽

Singleton Pregnancies

Sirenomelia is a rare developmental malformation and is incompatible to life. The incidence of sirenomelia, as recorded in the literature, is estimated to be approximately between 1.5 and 4.2 per 1,00,000 births. Around 15% of sirenomelia cases are associated with twin pregnancy, most often in monozygotic cases with an incidence of 7%. In monozygotic twins, the risk of sirenomelia is nearly 100–150 times higher as compared to dizygotic twins or singleton pregnancies. Until now, only two cases of sirenomelia associated with hypoplastic left heart have been reported in the literature. Here, we present a monozygotic twin pregnancy, where one fetus was diagnosed with sirenomelia associated with hypoplastic left heart syndrome and the co-twin was absolutely healthy.

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Twin Pregnancy with a Complete Hydatidiform Mole and a Coexisting Live Fetus: Rare entity

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2015.15.04.019 ◽

2015 ◽

Vol 15 (4) ◽

pp. e550-553 ◽

Cited By ~ 5

Author(s):

Shahila Sheik ◽

Nihal Al-Riyami ◽

Namitha R. Mathew ◽

Rashid Al-Sukaiti ◽

Asim Qureshi ◽

...

Keyword(s):

Twin Pregnancy ◽

Hydatidiform Mole ◽

Rare Entity ◽

Complete Hydatidiform Mole ◽

Live Fetus

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Second-Trimester Maternal Serum Markers in Twin Pregnancy with Complete Mole: Report of 2 Cases

Pediatric and Developmental Pathology ◽

10.1007/s10024-005-0121-9 ◽

2005 ◽

Vol 8 (2) ◽

pp. 230-234 ◽

Cited By ~ 9

Author(s):

Geralyn Lambert-Messerlian ◽

Halit Pinar ◽

Lewis P. Rubin ◽

Monique E. De Paepe ◽

Umadevi Tantravahi ◽

...

Keyword(s):

Twin Pregnancy ◽

Hydatidiform Mole ◽

Serum Marker ◽

Serum Markers ◽

Maternal Serum ◽

Second Trimester ◽

Singleton Pregnancy ◽

Maternal Serum Screening ◽

Complete Mole ◽

Pathology Reports

We present second-trimester serum marker levels in cases of twin pregnancy with complete hydatidiform mole and a coexistent fetus (CHMCF). Second-trimester inhibin A (InhA) levels have not been previously reported in such cases. Second-trimester maternal serum screening, α-fetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and InhA measurements combined with maternal age to estimate a patient's risk of Down syndrome during pregnancy was performed as a routine prenatal test in 2 cases of CHMCF. Hospital records containing serum marker data, patient history, pathology reports, and pregnancy outcome were reviewed. In cases of CHMCF, maternal serum AFP and uE3 levels were similar to those of a normal singleton pregnancy, whereas hCG and InhA levels were markedly increased. Second-trimester maternal serum marker profiles in cases of CHMCF are a composite of normal singleton and molar tissue secretions. We have found, for the first time, that second-trimester InhA levels are markedly increased in these cases. Serum marker levels may be useful in diagnosis of CHMCF, prenatal counseling, and evaluation of risk for persistent trophoblastic disease.

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Management of twin pregnancy with a hydatidiform mole and surviving healthy co-existent fetus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175297 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5636

Author(s):

Hale Goksever Celik ◽

Gözde Meriç Demirezen ◽

Baki Erdem ◽

Alev Atış Aydın ◽

Volkan Ülker

Keyword(s):

Maternal Morbidity ◽

Twin Pregnancy ◽

Hydatidiform Mole ◽

Uterine Cavity ◽

First Trimester ◽

Molar Pregnancy ◽

Complete Mole ◽

Live Fetus ◽

Twin Pregnancies ◽

Normal Placenta

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.

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