Background Complete hydatidiform mole and coexisting normal fetus pregnancies (CHMCF) are rare and can be life-threatening to the mother. Definitive diagnosis can be made with chorionic villus sampling or amniocentesis. However invasive procedures carry a risk of bleeding. We present the case of a twin molar pregnancy where a cell-free DNA screening test was utilized to evaluate for CHMCF pregnancy. Case A patient presented at 15-week gestational age with suspected CHMCF pregnancy. Ultrasound revealed a normal-appearing pregnancy abutting a multicystic lesion concerning for a complete mole. Cell-free DNA was obtained and was suggestive of complete paternal uniparental disomy. Pathological evaluation of the products of conception confirmed the diagnosis of CHMCF. Conclusion In atypical cases, cell-free DNA may be useful in evaluation of molar pregnancy.

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The prevalence of female pelvic floor disorders (PFDs) including urinary incontinence (UI) is felt to be high, however prior estimates vary. Estimates range from 1% to 50%, in part due to unreliable screening questionnaires for PFDs. The purpose of this study was to use the Epidemiology of Prolapse and Incontinence Questionnaire (EPIQ), a validated screening tool, to determine the prevalence of UI in women attending the Minnesota State Fair.METHODS: After IRB approval, the EPIQ was administered to women ! 18 years old attending the Minnesota State Fair in 2018. Data collection occurred over 6 half-day sessions at the University of Minnesota Driven to Discover building. Participants self-reported data using iPads connected to a secure web-based system, Research Electronic Data Capture (REDCap). Demographic data of age, height, and weight was collected and evaluated using descriptive statistics. Chi-square, Fisher's exact, Students t-test, or Wilcoxon rank-sum tests were used to analyze associations between variables and outcomes.RESULTS: A total of 1,568 subjects were surveyed: 1,270 (88%) were younger women age 18-64 years, and 173 (12%) were older women ! 65 years. Overall, 774 (49.5%) of participants reported any type of UI. The prevalence of stress urinary incontinence (SUI) and urge urinary incontinence (UUI) was 613 (40.7%) and 363 (24.1%), respectively. Older women had a statistically significant increased prevalence of UI compared to younger women, 97 (56.7%) vs. 597 (47%), p[0.02. UUI was also associated with older age and was endorsed by 53 (32.9%) of older and 273 (22.2%) of younger women. A higher mean BMI occurred in those with UI, 28.5 (SD[6.6), compared to those without, 25.8 (SD[5.6), p<0.01. There was a significant association between childbirth and any type of UI, SUI, UUI, and history of any UI surgery, all p<0.01. In total, 60 (3.8%) of women reported at least one surgery related to UI. Additionally, smoking status was significantly associated with any UI, SUI, and UUI, all p<0.01. UI was reported in 156 (63.4%) of past and 30 (50.8%) of current smokers vs. 580 (46.6%) of non-smokers.CONCLUSIONS: The prevalence of urinary incontinence in women in Minnesota was relatively high when reported on the validated EPIQ survey compared to previous studies. As expected, urinary incontinence was associated with older age, higher BMI, childbirth, and smoking. Further studies are needed to better assess why our cohort appears to have a higher risk of UI.