Live second trimester intrauterine pregnancy with invasive mole: a rare case report


  • Muskaan Chhabra Department of Obstetrics and Gynecology, Grant Govt Medical College and Sir J. J. Group of Hospitals, Mumbai, Maharashtra, India
  • Rekha Daver Department of Obstetrics and Gynecology, Grant Govt Medical College and Sir J. J. Group of Hospitals, Mumbai, Maharashtra, India



Beta HCG, Invasive mole, Live fetus, Myometrial invasion, Methotraxate


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.


Tempfer C, Horn LC, Ackermann S, Beckmann MW, Dittrich R, Einenkel J, et al. Gestational and non-gestational trophoblastic disease. guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF registry No. 032/049, december 2015). Obstet Gynecol. 2016;76(2):134.

Lybol C, Thomas CM, Bulten J, van Dijck JA, Sweep FC, Massuger LF. Increase in the incidence of gestational trophoblastic disease in The Netherlands. Gynecol Oncol. 2011;121(2):334-8.

Twiggs LB, Morrow CP, Schlaerth JB. Acute pulmonary complications of molar pregnancy. Am J Obstet Gynecol. 1979;135(2):189-94.

Rai l, Shripad H, Guruvare S, Prashanth A, Mundkur A. Twin pregnancy with Hydatidiform Mole and Co-existent Live Fetus: Lessons Learnt. MJMS. 2014;21(6):61-4.

Vaisbuch E, Ben-Arie A, Dgani R, Perlman S, Sokolovsky N, Hagay Z. Twin pregnancy consisting of a complete hydatidiform mole and co-existent fetus: report of two cases and review of literature. Gynecol Oncol. 2005;98(1):19-23.

Kashanian M, Baradaran HR, Teimoori N. Risk factors for complete molar pregnancy: a study in Iran. J Reprod Med. 2009;54(10):621-4.

Başbuğ M, Aygen E, Tayyar M, Kaya E, Demir I, Serin S. Recurrent molar pregnancy after ovulation induction and repeat ovulation induction. A case report. J Reprod Med. 1997;42(9):600-2.

Tse KY, Ngan HY. Gestational trophoblastic disease. Best Pract Res Clin Obstet Gynaecol. 2012;26(3):357-70.

Sebire NJ, Jauniaux E. Fetal and placental malignancies: prenatal diagnose and management. Ultrasound Obstet Gynecol. 2009;33(2):235-44.

Massardier J, Golfier F, Journet D, Frappart L, Zalaquett M, Schott AM, et al., Twin pregnancy with complete hydatidiform mole and coexistent fetus: obstetrical and oncological outcomes in a series of 14 cases. Eur J Obstet Gynecol Reprod Biol. 2009 Apr;143(2):84-7.






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