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

Abstract

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.