Management of a Dichorionic Twin Pregnancy with a Normal Fetus and an Androgenetic Diploid Complete Hydatidiform Mole

A coexistent molar pregnancy with a normal fetus is rare, with an incidence of 1 in 22.000 to 100.000 pregnancies-only 200 cases reported in the last two decades. The ultrasound is essential for an earlier diagnosis, and the management of these cases is challenging due to the increased risk of obstetrics complications and the possibility of posterior gestational trophoblastic neoplasia. Here we describe a 33-year-old healthy woman with a first-trimester twin pregnancy, presented with a normal fetus and a heterogeneous and vacuolar structure suggestive of complete hydatidiform mole. The pregnancy was interrupted, and a histological diagnosis confirmed complete hydatidiform mole in dichorionic/diamniotic twin pregnancy at 14 weeks. Molar twin pregnancy is a rare condition, and do not exist any consensus protocol to guide the clinical approach, so the decision to continue the pregnancy depends on the couple’s desire and maternal and fetal complications.

Download Full-text

A rare twin pregnancy: a normal fetus and a complete hydatidiform mole

Journal of Obstetrics and Gynaecology ◽

10.1080/01443610050009773 ◽

2000 ◽

Vol 20 (3) ◽

pp. 319-320 ◽

Cited By ~ 1

Author(s):

J. Slevin, R. Gleeson, P. McKenna

Keyword(s):

Twin Pregnancy ◽

Hydatidiform Mole ◽

Complete Hydatidiform Mole ◽

Normal Fetus

Download Full-text

Expectant Management of a Twin Pregnancy with Complete Hydatidiform Mole and Coexistent Normal Fetus

Case Reports in Obstetrics and Gynecology ◽

10.1155/2019/8737080 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Colin Johnson ◽

Caroline Davitt ◽

Rachel Harrison ◽

Meredith Cruz

Keyword(s):

Twin Pregnancy ◽

Hydatidiform Mole ◽

Expectant Management ◽

Fetal Monitoring ◽

Molar Pregnancy ◽

Complete Hydatidiform Mole ◽

Normal Fetus ◽

Healthy Female ◽

Negative Woman ◽

Inpatient Management

Twin pregnancies complicated by complete hydatidiform mole coexisting with a viable fetus are rare and may result in significant complications. We describe the expectant management and our surgical approach in a 27-year-old Rh-negative woman presenting with recurrent episodes of vaginal bleeding and a twin pregnancy consisting of a molar pregnancy coexisting with a normal fetus. Inpatient management was undertaken with close maternal and fetal monitoring until cesarean delivery of a healthy female infant and histopathologically confirmed complete hydatidiform molar pregnancy (karyotype 46XX) at 34 weeks with no evidence of malignancy.

Download Full-text

Twin Pregnancy with a Complete Hydatidiform Mole and a Coexisting Normal Fetus

Annals of Gynecology and Obstetrics ◽

10.36959/468/461 ◽

2018 ◽

Vol 2 (1) ◽

Author(s):

MR Fatnassi ◽

S Ghedas ◽

N Marouen ◽

A Mtibaa

Keyword(s):

Twin Pregnancy ◽

Hydatidiform Mole ◽

Complete Hydatidiform Mole ◽

Normal Fetus

Download Full-text

Complete Hydatidiform Mole Presenting as a Placenta Accreta in a Twin Pregnancy with a Coexisting Normal Fetus: Case Report

Case Reports in Obstetrics and Gynecology ◽

10.1155/2012/405085 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Marijo Aguilera ◽

Philip Rauk ◽

Rahel Ghebre ◽

Kirk Ramin

Keyword(s):

Twin Pregnancy ◽

Placenta Accreta ◽

Placenta Previa ◽

Hydatidiform Mole ◽

Male Infant ◽

Complete Hydatidiform Mole ◽

Normal Fetus ◽

Risk Pregnancy ◽

Internal Iliac ◽

Surgical Preparation

A twin pregnancy with a complete hydatidiform mole and a coexisting normal fetus (CHMF) is a rare clinical scenario, and it carries many associated pregnancy and postnatal risks. Limited numbers of case studies exist reporting an outcome of live birth, and only three prior cases report the presentation of a hydatidiform mole as a placenta previa. We report a case of CHMF with the molar component presenting antenatally as a placenta previa, which ultimately resulted in placenta accreta at the time of delivery. A live male infant was delivered at 34 weeks’ gestation via planned cesarean section, and a hysterectomy was performed following unsuccessful removal of the molar component. We additionally utilized previously described methods of placing internal iliac balloons and ureteral stents prior to delivery. In such a high-risk pregnancy with a known molar previa component, these surgical preparation measures may be of benefit.

Download Full-text