Complete mole in a dichorionic twin pregnancy after intracytoplasmic sperm injection

SummaryIn this report we present an unusual case of a couple who achieved a twin pregnancy by intracytoplasmic sperm injection (ICSI) with a single immature oocyte retrieved. The oocyte was at metaphase I at 39 h post human chorionic gonadotrophin (hCG) administration, which is our standard ICSI time. Extended culture allowed the extrusion of the polar body, and sperm injection was performed at 43 h post-trigger. The fertilized egg underwent embryo biopsy on day 3 and preimplantation genetic assessment for three chromosomes (X, Y and 21). The embryo remained in culture until day 5. Later, the biopsy results reported a transferable embryo, which was replaced to the uterine cavity at blastocyst stage. Pregnancy test gave a positive β-hCG result, and the 6 weeks’ scan, performed to confirm the fetal heart, revealed the presence of one amniotic sac and two fetal heartbeats, which currently have been so far eventless and smooth, ongoing at 18 weeks of gestation.

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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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Twin pregnancy with complete hydatiform mole and coexisting live fetus: A rare case report

10.36811/ojgor.2019.110006 ◽

2019 ◽

pp. 31-34

Author(s):

Swati Agrawal ◽

Kiran Aggarwal ◽

Anjali Singh ◽

Khushbu Saha ◽

Amrita Mishra ◽

...

Keyword(s):

Rare Case ◽

Twin Pregnancy ◽

Gestational Trophoblastic Disease ◽

Rare Entity ◽

Trophoblastic Disease ◽

Complete Mole ◽

Beta Hcg ◽

Rare Case Report ◽

Live Fetus

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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Neonatal outcome in a Danish national cohort of 8602 children born after in vitro fertilization or intracytoplasmic sperm injection: the role of twin pregnancy

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/j.0001-6349.2004.00476.x ◽

2004 ◽

Vol 83 (11) ◽

pp. 1071-1078 ◽

Cited By ~ 103

Author(s):

Anja Pinborg ◽

Anne Loft ◽

Anders Nyboe Andersen

Keyword(s):

In Vitro Fertilization ◽

Intracytoplasmic Sperm Injection ◽

Twin Pregnancy ◽

Neonatal Outcome ◽

Vitro Fertilization ◽

National Cohort

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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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