Ultrasound diagnosis of coexisting molar pregnancy following referral for abnormal serum screen

Monga, Manju; Mastrobattista, Joan M.; Schumacher, Vicki; Le, Donaldson

doi:10.1016/s0301-5629(03)00616-1

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“…One of the coexistent fetuses died in utero, and the other 2 delivered prematurely. There are numerous reports in the literature of twin pregnancy complicated by complete hydatidiform mole [4][5][6][7][8]. However, apart from the villous morphologic changes and molecular features of complete mole, the histology of these molar twin placentas is rarely studied.…”

Section: Discussionmentioning

confidence: 96%

Fetal Thrombotic Vasculopathy in Twin Placentas with Complete Hydatidiform Mole

Ernst

Parry

2009

Pediatr Dev Pathol

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Complete hydatidiform mole with a coexistent normal twin is rare, but the mortality rate for the coexistent twin is high, usually attributed to preeclampsia or vaginal bleeding. Placental examination of 3 twin pregnancies complicated by complete hydatidiform mole revealed significant abnormalities in the fetal vasculature. In 1 case, an intrauterine demise at 27 weeks, the placenta showed chorionic plate vessels with mural fibrin thrombi. The placenta from a second case, delivered at 30 weeks for preterm labor, showed similar thrombi in chorionic plate vessels, accompanied by calcification. A third case delivered at 35 weeks produced a liveborn infant, and the placenta showed villous stromal-vascular karyorrhexis, avascular villi, and stem villous thrombosis. Fetal placental thrombotic lesions seen in the coexistent twin circulation, associated with a complete hydatidiform mole, may play a heretofore unrecognized role in the morbidity and mortality of the fetus.

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