A twin pregnancy comprising a complete hydatidiform mole coexisting with a foetus is a rare obstetric condition with an incidence of 1 in 22,000 to 1 in 100,000 pregnancies. The management of such case is challenging due to the associated risk of maternal and foetal complications. We report a case of a 25-year-old woman, gravida 2, para 1 with a normal intrauterine pregnancy coexisting with complete hydatidiform mole. An ultrasound scan demonstrated normal foetus and placenta along with coexistent intrauterine echogenic mass with features of hydatidiform mole. The microscopic examination of the abnormal placenta confirmed complete hydatidiform mole. Although twin pregnancy with complete hydatidiform mole and coexistent foetus is associated with increased risk of developing maternal and foetal complications, continuation of pregnancy may be an acceptable option under close monitoring to detect early signs of complications.
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