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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (5): 1232-1247    DOI: 10.31083/j.ceog4805197
Case Report Previous articles |
Successful delivery of a twin pregnancy with complete hydatidiform mole and coexistent live fetus: a case report and review of literature
Neha Sethi1, *(), Ann Gee Tan1, Maherah Kamarudin1, Sofiah Sulaiman1
1Department of Obstetrics and Gynaecology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
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Abstract  
Background: A twin pregnancy consisting of either a complete or partial hydatidiform mole and a fetus is rare. The reported incidence ranges from 1:22,000–100,000 pregnancies, and complete hydatidiform mole with a coexistent fetus (CHMCF) comprises the majority of these cases. The management of CHMCF is controversial, as maternal risk with continuation of the pregnancy should be weighed against fetal survival. Women with CHMCF are at risk of developing preeclampsia, gestational diabetes, hyperthyroidism, antepartum hemorrhage, and gestational trophoblastic neoplasia. Case: We report a case of a healthy 32-year-old woman in her third pregnancy. She presented at 18 weeks gestation with vaginal bleeding and a significantly large uterus relative to the gestational age. Ultrasound showed CHMCF with a beta-hCG value of 398,800 IU/L. After careful discussion with the patient and after considering her options, she elected to continue the pregnancy. She was closely monitored for complications and had no maternal or fetal concerns. An elective cesarean delivery was performed at 32 weeks. A live female infant was delivered together with a normal placenta and a complete mole. The mother and baby were discharged in good condition after 2 days. A histopathological examination of the molar tissue confirmed the CHMCF diagnosis. No finding of gestational trophoblastic neoplasia (GTN) was discovered throughout one-year follow-up. Conclusion: Successful pregnancy outcomes can be achieved in cases of CHMCF. Comprehensive counseling with the patient regarding possible complications is important. Closely monitoring the mother for any complications and performing ongoing fetal surveillance are essential. Delivery should be planned at a tertiary center with good facilities and neonatal support.
Key words:  Complete hydatidiform mole      Twin pregnancy      Coexistent live fetus      Gestational trophoblastic neoplasia     
Submitted:  13 January 2021      Revised:  11 February 2021      Accepted:  12 March 2021      Published:  15 October 2021     
*Corresponding Author(s):  Neha Sethi     E-mail:  s_neha26@um.edu.my

Cite this article: 

Neha Sethi, Ann Gee Tan, Maherah Kamarudin, Sofiah Sulaiman. Successful delivery of a twin pregnancy with complete hydatidiform mole and coexistent live fetus: a case report and review of literature. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(5): 1232-1247.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog4805197     OR     https://ceog.imrpress.com/EN/Y2021/V48/I5/1232

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