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Year: 2008 Volume: 278 Issue: 3

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Twin pregnancy with a complete hydatidiform mole and surviving co-existent fetus.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Piura, Benjamin Rabinovich, Alex Hershkovitz, Relly Maor, Ester Mazor, Moshe
Description	Country affiliation: Israel Author Affiliation: Piura B ( Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 151, Beer-Sheva 84101, Israel. piura@bgu.ac.il)
Abstract	INTRODUCTION: Twin pregnancy with complete hydatidiform mole and co-existent fetus (CHMF) resulting in a healthy take-home baby is rare, with only 30 cases documented in detail in the literature. CASE REPORT: A 29-year-old woman conceived following two cycles of ovulation induction with clomiphene citrate. Successive ultrasound examinations demonstrated a normally growing live fetus alongside a normal placenta and an additional intrauterine echogenic mass with features of hydatidiform mole. At 17 week gestation, serum beta-hCG level was 25.38 multiples of the median. Genetic amniocentesis at 18.5 week gestation showed normal fetal 46XX karyotype. A cesarean section performed at 28 week gestation 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 confirmed complete hydatidiform mole. The baby did well and serial maternal serum beta-hCG levels showed a declining trend and were undetectable by 7 weeks after delivery. CONCLUSION: Continuation of a twin pregnancy with CHMF is an acceptable option. There is, however, an increased risk of developing pre-eclampsia and fetal loss due to miscarriage. The chance of a live term birth is <50% with nearly 33% of the mothers developing persistent gestational trophoblastic disease after delivery. Thus, close surveillance of an ongoing twin pregnancy with CHMF is mandatory to detect potential early signs of maternal and fetal complications.
File Format	HTM / HTML
ISSN	09320067
Issue Number	4
Volume Number	278
e-ISSN	14320711
Journal	Archives of Gynecology and Obstetrics
Language	English
Publisher	Springer
Publisher Date	2008-10-01
Publisher Place	Germany
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Obstetrics Discipline Gynecology Hydatidiform Mole Diagnosis Pregnancy Complications, Neoplastic Twins Uterine Neoplasms Chorionic Gonadotropin, Beta Subunit, Human Blood Female Humans Karyotyping Live Birth Pregnancy Premature Birth Ultrasonography, Prenatal Case Reports Journal Article Review
Content Type	Text
Resource Type	Case study Article
Subject	Obstetrics and Gynecology

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