Complete hydatidiform mole with co-existing fetus: Predictors of live birth

Suksai, Manaphat; Suwanrath, Chitkasaem; Kor-anantakul, Ounjai; Geater, Alan; Hanprasertpong, Tharangrut; Atjimakul, Thiti; Pichatechaiyoot, Aroontorn

doi:10.1016/j.ejogrb.2017.03.013

Cited by 39 publications

(59 citation statements)

References 13 publications

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“…In the US, HM occurs between 0.5 and 2.5 per 1000 pregnancies [3]. Twin gestation with HM is even rarer with an estimated incidence of 1 per 20,000 to 100,000 pregnancies [4] and is associated with severe maternal complications (massive vaginal bleeding, hyperemesis gravidarum, hyperthyroidism, preterm delivery, pregnancy-induced hypertension, preeclampsia, trophoblastic embolization, and gestational trophoblastic neoplasia) and fetal complications (fetal death) [1,[4][5][6]. A literature review by Lin et al revealed a regional difference in clinical presentation of CHMCF with a higher rate of life-threatening conditions in South America compared to North America [1].…”

Section: Discussionmentioning

confidence: 99%

Delivery of Euthyroid Baby following Hyperthyroidism in Twin Gestation with Coexisting Complete Hydatidiform Mole

Raj

Hager

et al. 2019

Case Reports in Endocrinology

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Context. Gestational trophoblastic disease (GTD) is a rare complication of pregnancy, ranging from molar pregnancy to choriocarcinoma. Twin pregnancies with GTD and coexisting normal fetus are extremely rare with an estimated incidence of 1 case per 22,000–100,000 pregnancies. Molecular mimicry between human chorionic gonadotrophin (hCG) and thyroid-stimulating hormone (TSH) leads to gestational trophoblastic hyperthyroidism (GTH) which is further associated with increased maternal and fetal complications. This is the first reported case in literature describing the delivery of a baby with biochemical euthyroid status following a twin pregnancy with hydatidiform mole (HM) associated with gestational trophoblastic hyperthyroidism (GTH). Case Description. A 24-year-old G4 P3 Caucasian female with twin gestation was admitted to hospital for gestation trophoblastic hyperthyroidism. She was later diagnosed to have twin pregnancy with complete mole and coexisting normal fetus complicated by gestational trophoblastic hyperthyroidism (GTH). Despite the risk associated with the continuation of molar pregnancy, per patient request, pregnancy was continued till viability of the fetus. The patient underwent cesarean section due to worsening preeclampsia and delivered a euthyroid baby at the 24th week of gestation. Conclusions. Twin pregnancy with gestational trophoblastic disease and coexisting normal fetus is associated with high risk of hyperthyroidism, and careful monitoring of the thyroid function test along with dose titration of thionamides is of utmost importance throughout the gestation. If normal thyroid hormone levels are maintained during the pregnancy, euthyroidism could be successfully achieved in the baby.

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Section: Discussionmentioning

confidence: 99%

Delivery of Euthyroid Baby following Hyperthyroidism in Twin Gestation with Coexisting Complete Hydatidiform Mole

Raj

Hager

et al. 2019

Case Reports in Endocrinology

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“…Единой точки зрения на тактику ведения многоплодной беременности с ППЗ в настоящее время не существует. Осложнения при многоплодной беременности с ППЗ развиваются чаще, чем при изолированном ППЗ [11]. В связи с наличием жизнеспособного плода остро встает вопрос о возможности и целесообразности пролонгирования беременности, связанной с высоким риском развития угрожающих жизни осложнений.…”

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“…В связи с наличием жизнеспособного плода остро встает вопрос о возможности и целесообразности пролонгирования беременности, связанной с высоким риском развития угрожающих жизни осложнений. В случае пролонгирования живорождение наступает примерно в 1 / 3 беременностей, средний срок родоразрешения составляет 30 нед; отмечена высокая интранатальная и ранняя неонатальная летальность [11,12].…”

unclassified

“…В литературе, посвященной анализу наблюдений многоплодной беременности с ППЗ, особое внимание придается оценке риска развития ПТБ у таких пациенток. Частота ПТБ при многоплодной беременности с ППЗ, согласно данным литературы [11,13,14], составляет от 37 до 50%, что существенно выше, чем при одноплодной беременности с ППЗ. Вместе с тем, по данным N. Sebire и соавт.…”

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A complete hydatidiform mole in multiple pregnancy

Voloshchuk¹,

Barinova²,

Kovalenko³

et al. 2018

Ross. vestn. akush.-ginekol.

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Представлены два наблюдения редкого состояния-сочетания полного пузырного заноса и развивающегося плода с нормальной плацентой при многоплодной беременности. Описаны особенности течения беременности, ультразвуковая картина, морфологические и иммуногистохимические признаки данного состояния. При сочетании полного пузырного заноса с нормальной плацентарной тканью и жизнеспособным плодом остро встает вопрос о возможности и целесообразности пролонгирования беременности, связанной с высоким риском развития угрожающих жизни осложнений, включая персистирующую трофобластическую болезнь. В статье обсуждаются принципы диагностики данной патологии, дифференциальный диагноз, тактика ведения пациенток. Ключевые слова: полный пузырный занос, частичный пузырный занос, многоплодная беременность, тактика ведения, персистирующая трофобластическая болезнь, ультразвуковая картина, гистологическое исследование, иммуногистохимическое исследование, р57.

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“…1 In present case, a twin molar pregnancy was diagnosed in the first trimester by ultrasound. Close follow-up is an option in the management of these pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Management of twin pregnancy with a hydatidiform mole and surviving healthy co-existent fetus

Çelik

Demirezen

Erdem³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Twin pregnancies with complete mole and a coexisting live fetus are rare obstetric conditions seen in 1 case of 22000 to 100000 pregnancies. In our case, a twin molar pregnancy was diagnosed in the first trimester by ultrasound. In a 27-year-old patient with the first pregnancy, a 12-week live fetus with a normal placenta and a twin molar pregnancy appearance were observed on a routine ultrasonographic examination of the uterine cavity. Twin molar pregnancies are reported to be terminated by live birth in the literature, but termination of pregnancy is an important option to prevent maternal morbidity since molar pregnancy may lead to complications ranging from theca lutein cysts to gestational trophoblastic neoplasia.

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Complete hydatidiform mole with co-existing fetus: Predictors of live birth

Cited by 39 publications

References 13 publications

Delivery of Euthyroid Baby following Hyperthyroidism in Twin Gestation with Coexisting Complete Hydatidiform Mole

Delivery of Euthyroid Baby following Hyperthyroidism in Twin Gestation with Coexisting Complete Hydatidiform Mole

A complete hydatidiform mole in multiple pregnancy

Management of twin pregnancy with a hydatidiform mole and surviving healthy co-existent fetus

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