Management of twin pregnancy with a hydatidiform mole and surviving healthy co-existent fetus
Keywords:Gestational trophoblastic disease (GTD), Hydatiform mole, Twin pregnancy
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.
Suksai M, Suwanrath C, Kor-Anantakul O, Geater A, Hanprasertpong T, Atjimakul T et al. Complete hydatidiform mole with co-existing fetus: Predictors of live birth. Eur J Obstet Gynecol Reprod Biol. 2017;212:1-8.
Vimercati A, de Gennaro AC, Cobuzzi I, Grasso S, Abruzzese M, Fascilla FD, et al. Two cases of complete hydatidiform mole and coexistent live fetus. J Prenat Med. 2013;7(1):1-4.
Peng HH, Huang KG, Chueh HY, Adlan AS, Chang SD, Lee CL. Term delivery of a complete hydatidiform mole with a coexisting living fetus followed by successful treatment of maternal metastatic gestational trophoblastic disease. Taiwan J Obstet Gynecol. 2014;53(3):397-400.
Piura B, Rabinovich A, Hershkovitz R, Maor E, Mazor M. Twin pregnancy with a complete hydatidiform mole and surviving co-existent fetus. Arch Gynecol Obstet. 2008;278(4):377-82.
Kutuk MS, Ozgun MT, Dolanbay M, Batukan C, Uludag S, Basbug M. Sonographic Findings and Perinatal Outcome of Multiple Pregnancies Associating a Complete Hydatiform Mole and a Live Fetus: A Case Series. J Clin Ultrasound. 2014;42(8):465-71.
Lin LH, Maesta I, Braga A, Sun SY, Fushida K, Francisco RPV et al. Multiple pregnancies with completemole and coexisting normal fetus in North and South America: A retrospective multicenter cohort and literature review. Gynecol Oncol. 2017;145:88-95.
Rohilla M, Singh P, Kaur J, Jain V, Gupta N, Prasad GRV. Individualistic approach to the management of complete hydatidiform mole with coexisting live fetus. Eur J Obstet Gynecol Reprod Biol. 2015;191:39-42.
Bruchim I, Kidron D, Amiel A, Altaras M, Fejgin MD. Complete hydatidiform mole and a coexistent viable fetus: report of two cases and review of the literature. Gynecol Oncol. 2000;77:197-202.