Complete hydatidiform mole with a twin pregnancy at 26 weeks: a rare obstetric complication

Successful delivery of a twin pregnancy with complete hydatidiform mole and coexistent live fetus: a case report and review of literature

“…Fetal karyotyping has been advocated to compare the normal chromosome number in CHMCF compared with the triploidy seen in a partial mole [2,4,6,10,39,45,109,116,117]. Complete mole is exclusively diploid and paternal in origin, occurring when an "empty" ovum is being fertilized by a single haploid sperm that duplicates (46,XX) or by two haploid sperms (46, XX or 46, XY) [2,4,5,45].…”

“…However, it has been demonstrated that the risk of GTN is independent of gestational age, meaning that the risk of GTN in patients who choose conservative management until delivery is the same as that in those who decide to terminate the pregnancy [2,11,12,60,118,119]. Therefore, in the recent years, continuation of the pregnancy has become an option [2,3,12,14,116,118], provided that the patient has access to a high standard of care under a multidisciplinary team at a tertiary hospital, does not develop any serious uncontrollable complications throughout the pregnancy, and can maintain compliance with regular follow-up during close surveillance [2,3,10,12,14,108,119,122]. Comprehensive counseling involving obstetricians, gynaecologic oncologists, anesthetists and neonatologists with the couple must be performed, and they need to understand the risk of possible obstetric complications before this major decision is made [9,10,14,38,116,118,119].…”

“…Therefore, in the recent years, continuation of the pregnancy has become an option [2,3,12,14,116,118], provided that the patient has access to a high standard of care under a multidisciplinary team at a tertiary hospital, does not develop any serious uncontrollable complications throughout the pregnancy, and can maintain compliance with regular follow-up during close surveillance [2,3,10,12,14,108,119,122]. Comprehensive counseling involving obstetricians, gynaecologic oncologists, anesthetists and neonatologists with the couple must be performed, and they need to understand the risk of possible obstetric complications before this major decision is made [9,10,14,38,116,118,119]. The antenatal care included serial beta-hCG, haemoglobin and thyroid function measurements as well as monitoring of the progression of molar mass, theca lutein cysts and fetal growth [34,41,44,56].…”

“…However, a cesarean section was performed at 32 weeks gestation due to a plateau of fetal growth and because the patient had also complained of uterine contractions. Regular monitoring of the hCG levels throughout the pregnancy and postpartum period is necessary to detect GTN [116,119,122]. Furthermore, the patient should be treated with chemotherapy [11,13,38] when GTN is suspected.…”