Complete mole coexistent with a twin fetus

Abstract

We report two cases of a complete hydatidiform mole coexistent with a live fetus diagnosed by DNA polymorphism analysis. A 27-year-old woman revealed symptoms of pre-eclampsia and ultrasound showed multicystic tumor and placenta coexistent with a live fetus at 16 weeks' gestation. The placenta with partly hydropic change and the fetus without anomaly were consequently evacuated. Another 30-year-old woman had a multicystic mass attached to a normal placenta with a 20-week live fetus on ultrasound examination. A hysterotomy was carried out because of persistent bleeding due to placenta previa. In both cases, DNA was extracted from the placental tissue and the tumor, as well as from maternal and paternal blood. Genetic analysis demonstrated that the placental tumor consisted of only paternal origin, which is consistent with the diagnosis of complete hydatidiform mole.

Metastatic Gestational Trophoblastic Disease Following a Complete Hydatidiform Mole Coexistent With an Anencephalic Fetus Diagnosed at 10 Weeks' Gestation

“…[3][4][5][6][7][8] Patients with an isolated CHM have a 15% to 20% risk of pGTD. The available literature addressing pGTD in twin gestations involving a hydatidiform mole and a structurally normal live fetus is conflicting.…”

“…2 Complications associated with a molar pregnancy, such as hypertensive disorders of pregnancy, hyperthyroidism, hemorrhage, pulmonary edema, and thromboembolic phenomena, appear to be increased among CHMs coexistent with a live twin fetus. [3][4][5][6][7][8] Also, there may be a higher risk of persistent gestational trophoblastic disease (pGTD) in these patients than in patients with an isolated CHM pregnancy. [3][4][5][6][7][8] In most reports of complete moles coexistent with a live fetus, the live fetus is structurally and karyotypically normal.…”

“…[3][4][5][6][7][8] Also, there may be a higher risk of persistent gestational trophoblastic disease (pGTD) in these patients than in patients with an isolated CHM pregnancy. [3][4][5][6][7][8] In most reports of complete moles coexistent with a live fetus, the live fetus is structurally and karyotypically normal. We report the sonographic findings of metastatic gestational trophoblastic disease following a twin gestation with a complete mole and a live anencephalic fetus.…”

Uterine Rupture in Twin Pregnancy with Normal Fetus and Complete Hydatidiform Mole

“…There has even been a report of a primary pulmonary choriocarcinoma [11]. Some authors have found the risk of severe preeclampsia to be elevated (25.8%) in CHMTF [12,13], but others have not found any significant differences with respect to singleton complete molar pregnancies [14]. Severe preeclampsia is indicative of poor outcome and is usually correlated with the presence of a theca-lutein cyst [15].…”

“…According to some reports, CHMTF carries more risk than a singleton complete mole, with reported rates of 55% [20], 43% [12] and 50% [5,18]. Vaisbuch et al [21] suggested that abnormal trophoblastic tissue was more aggressive in twin pregnancies, but Sebire et al [22], who have published the largest series to date (77 cases), reported a similar risk level to that seen with singleton complete moles (16%).…”