The role of magnetic resonance imaging in the diagnosis of complete hydatidiform mole in a twin pregnancy

Herek, Duygu; Karabulut, Nevzat

doi:10.1016/j.ijgo.2013.04.020

Cited by 6 publications

(6 citation statements)

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“…7,8 In 4 out of 6 cases (66.6%) that were terminated during second trimester, three were medically induced and one by unspecified method, the patients subsequently developed persistent trophoblastic disease and lung metastasis. [9][10][11][12][13] Four cases that were terminated by Caesarean section, one in second trimester and three in the third trimester did not develop PTD or metastasis, with delivery of live infants. [14][15][16][17][18][19] Present case, the PHMCF was terminated by medical method at 25 weeks, using misoprostol and the patient did not develop PTD after three months of follow up.…”

Section: Discussionmentioning

confidence: 98%

“…Advances in transvaginal ultrasound and MRI may help in the diagnosis of HMCF in the first trimester; however, HMCF is most often diagnosed at 15-20 weeks of gestation or later. 7,12,13 The empirical management of these pregnancies in second trimester is difficult. Dilatation and evacuation is the treatment used for molar pregnancies but presence of fetal structures precludes the use of this method.…”

Section: Discussionmentioning

confidence: 99%

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Medical termination of a partial hydatidiform mole with coexisting fetus during second trimester; management dilemma: a case report

Behura

Paul

Seth

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Partial hydatidiform mole and coexisting foetus is a rare condition, with an incidence of 122,000-1,000,000 pregnancies. It presents a dilemma for obstetricians when detected in second trimester of pregnancy. Medical termination is effective during second trimester; however, it increases the risk of occurrence of persistent trophoblastic disease. Following a review of literature, it was seen that most of the PHMCF terminated by medical induction during second trimester resulted in the development of PTD and lung metastasis. However, cases terminated by caesarean section during the third trimester did not develop PTD or metastasis. A 34 year old woman, gravida 3 para 2 at 25 weeks and 3 days of gestation, presented with absent fetal movements. She was markedly pale. She had no prior antenatal visits. Ultrasound examination revealed a single intrauterine foetus at 23 weeks of gestation with no cardiac activity. Spalding sign was positive. Liquor was reduced and showed internal echoes, secondary to intramniotic bleed. Placenta was grossly enlarged, anterior in location with multiple cystic areas suggestive of a partial mole. As her haemoglobin was 5.6 grams, she was transfused with 3 units of packed cells. The patient underwent induced medical abortion after counselling for risk of persistent trophoblastic disease and long term follow up. She was followed up with weekly serial serum beta hCG monitoring, which returned to normal within a month. She showed no signs of persistent trophoblastic disease at 3 months follow up and has been advised to continue follow up for a year. Mid-trimester termination of pregnancy due to PHMCF is challenging due to high risk of PTD and metastasis associated with it. Performance of caesarean section is not recommended during second trimester of pregnancy but is a relatively safer strategy to avoid the risks of persistent trophoblastic disease.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Medical termination of a partial hydatidiform mole with coexisting fetus during second trimester; management dilemma: a case report

Behura

Paul

Seth

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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“…Magnetic resonance imaging can be a useful adjunct to ultrasound for visualizing the normal placental site, the relationship between the fetus and vesicles, and the extension of the disease to the myometrium and parametrium. However, its diagnostic effect in early pregnancy remains unclear[7]. Although several PHMCF cases have been successfully diagnosed during the first trimester[8-11], the overall diagnosis rate is still low.…”

Section: Discussionmentioning

confidence: 99%

Termination of a partial hydatidiform mole and coexisting fetus: A case report

Zhang

2019

WJCC

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BACKGROUNDWe describe the treatment strategy for a patient who was found to have a partial hydatidiform mole and coexisting fetus (PHMCF) during the second trimester. The patient was a 38-year-old Chinese woman who had become pregnant following in vitro fertilization and embryo transplantation. We wanted to determine the safest therapeutic strategy to terminate the PHMCF during the second trimester.CASE SUMMARYIn this case, we present a patient who was found to have a PHMCF complicated with serious continuous vaginal bleeding and pre-eclampsia during the second trimester. After careful evaluation, the pregnancy was considered to be unsustainable and was terminated via caesarean section (CS). An infant with weak vital signs and a partially cystic placenta measuring 110 mm × 95 mm × 35 mm were delivered by CS. The patient was discharged after 4 d. The serum levels of β-human chorionic gonadotropin decreased to within a normal range 5 wk after the operation, and no evidence of persistent trophoblastic disease or lung metastases was noticed at the 6-mo follow-up.CONCLUSIONCS termination of PHMCF during the second trimester may be a relatively safe therapeutic strategy.

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“…68 % [3]. Als hilfreiche Alternative steht die MRT-geführte Bildgebung zur Wahl [4,12], zur genauen Differenzierung sind auch vielversprechende Ergebnisse zur [18 F]fluorodeoxyglucose-Positronen-Emissionstomografie in Kombination mit der Computertomografie publiziert worden [5]. Man unterscheidet zwischen partiellen und kompletten Molen.…”

Section: Gebfra Scienceunclassified

Twin Pregnancy with One Fetus and One Complete Mole – A Case Report

Freis

Elsässer

Sohn

et al. 2016

Geburtshilfe Frauenheilkd

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A 33-year-old GII/P0 was examined at 14 + 2 weeks gestation. In addtion to one eutrophic fetus with a normal placenta a second amniotic cavity with honeycomb-like structure was found (60 × 32 mm), so that a diagnosis of CMCF was suspected (l " Figs. 3 and 4). Metastases were excluded clinically. The beta hCG level fell continuously from the 17th week of gestation onwards (l " Fig. 1). No signs of preeclampsia, HELLP syndrome or hyperthyroidism were detected under close observation.The suspected diagnosis was confirmed at caesarean section, which was performed without delay at 31 + 4 weeks gestation in view of heavy vaginal bleeding most probably due to early premature placental abruption. A male infant weighing 1900 g was delivered with Apgar scores of 7/8/9 at 1, 5 and 10 minutes. Arterial pH = 7.35, venous pH = 7.37 and base excess was − 0.4; decision-to-delivery time was 10 minutes. The pathology showed an almost completely necrotic hydatidiform mole (l " Figs. 2 and 5) without evidence of choriocarcinoma. Maternal haemoglobin was 10.3 g/dl postoperatively compared to a preoperative level of 13.2 g/dl.Abstract !

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The role of magnetic resonance imaging in the diagnosis of complete hydatidiform mole in a twin pregnancy

Cited by 6 publications

References 4 publications

Medical termination of a partial hydatidiform mole with coexisting fetus during second trimester; management dilemma: a case report

Medical termination of a partial hydatidiform mole with coexisting fetus during second trimester; management dilemma: a case report

Termination of a partial hydatidiform mole and coexisting fetus: A case report

Twin Pregnancy with One Fetus and One Complete Mole – A Case Report

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