Complete hydatidiform mole in a triplet pregnancy coexisting two viable fetuses: Case report and review of the literature

Abstract

We report a rare case of a complete hydatidiform mole with two or more coexisting fetuses where both infants survived without complications. A male infant weighing 1258 g and a female infant weighing 880 g were delivered without complications and discharged 95 days after the birth. The analysis of DNA microsatellite polymorphisms indicated that the mole was of paternal origin and probably homozygous. The mother suffered from multiple pulmonary metastasis of the hydatidiform mole which was detected 3 days after the surgery and was successfully treated with methotrexate. A complete hydatidiform mole with two or more coexisting fetuses produces a dilemma between immediate termination and pregnancy continuation. Although the present case resulted in a favorable outcome, a review of the 14 reported cases suggests that the high fetal loss rate (90%) must be a consideration in the decision regarding management of such a pregnancy.

Routine histopathologic analysis of product of conception following first‐trimester spontaneous miscarriages

“…On the contrary, the histologic features of complete and partial hydatidiform molar early pregnancy loss are so distinctive that most cases of molar early pregnancy loss are correctly diagnosed by histologic examination alone; 11 this was the finding of Takagi et al . in their report of a rare case of complete hydatidiform mole with two or more coexisting fetuses where both infants survived without complications 12 …”

Clinical Findings of Multiple Pregnancy With a Complete Hydatidiform Mole and Coexisting Fetus

“…So far, there are about 14 case reports of triplet or quadruplet pregnancies with a CHMCF, and 11 of 14 cases were associated with infertility treatment. 7 Prenatal diagnosis by chorionic villus sampling, amniocentesis, or fetal cord blood sampling enables the physician to distinguish between diploid and triploid fetuses. In addition, molecular analysis is very important in prediction of the maternal outcome.…”

Viable triplet pregnancy coexisting with a complete molar pregnancy

“…In addition, the reported incidence of PTD and chemotherapy treatment was not significantly higher than in a singleton complete molar pregnancy according to some reports. Added to these factors, gestational age at diagnosis was not different in PTD incidence or disease prognosis . All these risk calculations were considered when the discussion was of a complete molar pregnancy with one or two coexisting fetuses, but in our case, there were three coexisting fetuses.…”