Twin pregnancy with a complete hydatidiform mole and surviving co-existent fetus: a case report

ABSTRACT

A 27-year-old woman conceived following six cycles of ovulation induction with clomiphene citrate. Successive ultrasound [US] examinations documented a normally growing live fetus with a normal placenta and an additional intrauterine echogenic mass with features of molar pregnancy. Follow-up serum beta-hCG estimation and genetic amniocentesis was done. Fetus revealed normal female 46XX karyotype. The pregnancy was continued till 28[th] weeks. Labor was induced at 28 week gestation due to vaginal bleeding, which resulted in the delivery of a live normal female infant and two adjoining placentas. One placenta was normal and the other placenta was composed of vesicles of various sizes. Microscopic examination of the abnormal placenta documented complete hydatidiform mole [[HM]. The baby was well and serial maternal serum beta-hCG levels showed a declining trend and were undetectable by 8 weeks after delivery. The prenatal diagnosis of twin pregnancy with complete HM and coexistent fetus was based on US findings, abnormally elevated beta-hCG levels and normal fetal karyotype [46XX]. The pregnancy should be continued with close follow-up to detect potential maternal and fetal complications