A challenging case of twin pregnancy with complete hydatidiform mole and co-existing normal live fetus – A case report and review of the literature

Lipi, LB; Philp, Lauren; A, Goodman

doi:10.1016/j.gore.2019.100519

Cited by 18 publications

(38 citation statements)

References 35 publications

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“…Gestational trophoblastic disease includes a large number of tumors that are interrelated, and with different propensities for local invasion and metastasis. Presenting as complete and partial hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor [5,6].…”

Section: Discussionmentioning

confidence: 99%

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Hydatidiform Mole Coexisting with Healthy and Alive Fetus at Birth: Case Report in Mexico

Mireles

Alvarez

Lopez

et al. 2021

AJMAH

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Aims: To describe a case of hydatidiform mole coexisting with healthy and alive fetus at birth in Mexico. Presentation of Case: A 35 years old pregnant patient at 18+5 weeks of gestational age and a viable fetus by ultrasound, with atypical pneumonia, plus scant bilateral pleural effusion and partial mole implants on admission to hospital. At week 39 of gestation, the pregnancy was interrupted abdominally; a gestation product was obtained, alive, female, and without malformations. The patient did not present complications. The histopathological report of the placenta was compatible with a partial mole. Discussion: Gestational trophoblastic disease includes partial hydatidiform mole, its occurrence in coexistence with alive and healthy fetus at birth is 0.005-0.01% respect to the total number of pregnancies. The viability of the term of pregnancy will depend on maternal comorbidities, fetalsss well-being and accessible medical surveillance. The ultrasound is the main diagnostic tool. Clinical monitoring is of vital importance after the end of pregnancy, mainly in mother, due to the risk of developing metastatic disease and recurrence of molar pregnancy. Conclusion: The case report described is relevant, due to its infrequency. In addition, the imaging findings, emphasizes the importance of a complete and adequate evaluation of the placenta and the fetus, in viable gestation conditions in coexistence with partial mole.

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Section: Discussionmentioning

confidence: 99%

“…The serious risks and complications that can occur during pregnancy, before and after delivery [5] require a timely differential diagnosis, providing the basis to proper management and follow-up. The objective of the present work is to describe a case of hydatidiform mole that coexists with alive and healthy fetus at birth in Mexico.…”

Section: Introductionmentioning

confidence: 99%

Hydatidiform Mole Coexisting with Healthy and Alive Fetus at Birth: Case Report in Mexico

Mireles

Alvarez

Lopez

et al. 2021

AJMAH

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“…Curry et al reported that only 64% (18 out of 24) of patients achieved spontaneous remission after hysterotomy, compared to 81% (243 out of 299) after suction evacuation [ 17 ]. More recently, use of abdominal hysterotomy for evacuation has been confined to case reports of coexistent mole and a live twin fetus, due to obstetric indications such as placenta previa, or prematurity and breech presentation, or HELLP Syndrome [ 18 , 19 , 20 ].…”

Section: Surgery For Hydatidiform Molementioning

confidence: 99%

Surgery including fertility-sparing treatment of GTD

Ngu

Ngan

2021

Best Practice & Research Clinical Obstetrics & Gynaecol

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Gestational trophoblastic disease (GTD) consist of a spectrum of diseases, including hydatidiform moles, invasive mole, metastatic mole, choriocarcinoma, placental site trophoblastic tumour (PSTT) and epithelioid trophoblastic tumour (ETT). GTD are relatively uncommon disease occurring in women of reproductive age, with high cure rates. Primary treatment of hydatidiform moles includes uterine evacuation, followed by close monitoring of serial hCG levels to detect for post-molar gestational trophoblastic neoplasia (GTN). In patients with GTN, the main therapy consists of chemotherapy, although some surgical procedures are important in selected patients in order to achieve cure. Hysterectomy is the mainstay treatment for PSTT or ETT, and may be considered in selected patients for management of hydatidiform mole and malignant GTN especially in chemoresistant disease. Resection of metastatic lesions such as in the lung or brain can be considered in selected patients with isolated chemoresistant tumour. Surgical treatment of GTD will be discussed in this chapter.

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“…Although largely unclear, the aetiology of gestational trophoblastic disease likely involves genetic abnormalities involved in fertilization. 1,2 Coexistent molar pregnancy with a normal fetus is a scarce situation, with most of the cases diagnosed antepartum by ultrasound findings of a complex, cystic placental component distinct from the fetoplacental unit. 3 It has an incidence of 1 in 22.000 to 100.000 pregnancieswith only about 200 cases reported in past two decades.…”

Section: Introductionmentioning

confidence: 99%

“…4 Management of these cases is challenging due to the increased risk of antenatal and perinatal complications and the risk of developing gestational trophoblastic neoplasia after delivery. 2 It is essential to provide proper patient counselling regarding pregnancy continuation and alert for maternal and fetal risks.…”

Section: Introductionmentioning

confidence: 99%

Coexistent molar pregnancy with a normal fetus-a rare presentation of gestational trophoblastic disease

Nascimento¹,

Veiga²,

Silva³

et al. 2021

Int J Reprod Contracept Obstet Gynecol

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A coexistent molar pregnancy with a normal fetus is rare, with an incidence of 1 in 22.000 to 100.000 pregnancies-only 200 cases reported in the last two decades. The ultrasound is essential for an earlier diagnosis, and the management of these cases is challenging due to the increased risk of obstetrics complications and the possibility of posterior gestational trophoblastic neoplasia. Here we describe a 33-year-old healthy woman with a first-trimester twin pregnancy, presented with a normal fetus and a heterogeneous and vacuolar structure suggestive of complete hydatidiform mole. The pregnancy was interrupted, and a histological diagnosis confirmed complete hydatidiform mole in dichorionic/diamniotic twin pregnancy at 14 weeks. Molar twin pregnancy is a rare condition, and do not exist any consensus protocol to guide the clinical approach, so the decision to continue the pregnancy depends on the couple’s desire and maternal and fetal complications.

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A challenging case of twin pregnancy with complete hydatidiform mole and co-existing normal live fetus – A case report and review of the literature

Cited by 18 publications

References 35 publications

Hydatidiform Mole Coexisting with Healthy and Alive Fetus at Birth: Case Report in Mexico

Hydatidiform Mole Coexisting with Healthy and Alive Fetus at Birth: Case Report in Mexico

Surgery including fertility-sparing treatment of GTD

Coexistent molar pregnancy with a normal fetus-a rare presentation of gestational trophoblastic disease

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