Triplet pregnancy with partial hydatidiform mole coexisting with two fetuses: A case report

Kim, Cheol Hong; Kim, Yoon Ha; Kim, Jong Woon; Kim, Kimin; Cho, Moon Kyoung; Kim, Seok Mo; Nam, Jong Hee; Song, Tae Bok

doi:10.1111/j.1447-0756.2008.00899.x

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…The management of such pregnancies presents a dilemma for physicians and parents between expectant management and immediate intervention; particularly in pregnancies involving assisted reproductive technology (8)(9)(10). A small number of cases of PHMCF …”

Section: Discussionmentioning

confidence: 99%

“…However, parents must also be aware of the risk of potential maternal complications associated with molar pregnancy, including early-onset preeclampsia, hyperemesis gravidarum, PTD and metastases (13). To the best of our knowledge, following an extensive search of the relevant medical literature since the year 2000, 10 PHMCF cases have previously been reported (Table I) (8)(9)(10)(11)(12)(14)(15)(16)(17)(18). Two of these cases of PHMCF were treated by termination of pregnancy during the first trimester, via dilatation and suction curettage, resulting in one case of PTD and no metastases (8,14).…”

Section: A B a Bmentioning

confidence: 99%

“…Two of these cases of PHMCF were treated by termination of pregnancy during the first trimester, via dilatation and suction curettage, resulting in one case of PTD and no metastases (8,14). In 3/5 cases (60%) that were terminated during the second trimester, two by medically induced labor and the other via unspecified methodology, the patient subsequently developed PTD and lung metastases (9,10,15). Finally, three cases that were terminated by caesarean section in the third trimester did not develop PTD or metastases, and resulted in the delivery of live infants (although one infant succumbed 30 days subsequent to delivery) (11,12,18).…”

Section: A B a Bmentioning

confidence: 99%

“…Mid-trimester TOP due to PHMCF is challenging (9,10). Due to the rarity of this condition, minimal relevant data has been amassed, meaning that it is difficult to formulate valid predictions for treatment and outcomes of patients presenting with PHMCF during the second trimester.…”

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Medical termination of a partial hydatidiform mole and coexisting fetus during the second trimester: A case report

2015

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Abstract. Partial hydatidiform mole and coexisting fetus (PHMCF) is a rare condition that presents a dilemma for physicians and the parents of the fetus, particularly when PHMCF is detected during the second trimester of pregnancy. The present study reports a case of PHMCF terminated by induction of labor via administration of Rivanol at 17 weeks. Follow-up measurements of serum β-human chorionic gonadotropin (β-HCG) levels, as well as imaging studies, indicated the presence of persistent trophoblastic disease (PTD) and lung metastases. The patient was therefore admitted for three courses of chemotherapy. Subsequently, the metastases receded and β-HCG levels decreased to within the normal range. The patient demonstrated no disease recurrence for 1 year. Following a review of the relevant literature, to the best of our knowledge, all PHMCF cases terminated by medical induction of labor during the second trimester resulted in the development of PTD and lung metastases. However, three cases of PHMCF that were terminated by caesarean section during the third trimester did not develop PTD or metastases. The present study therefore hypothesized that medical termination may not be a safe therapeutic strategy for the treatment of PHMCF during the second trimester, and that pregnancy should be allowed to continue empirically.

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Section: Discussionmentioning

confidence: 99%

Section: A B a Bmentioning

confidence: 99%

Section: A B a Bmentioning

confidence: 99%

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Medical termination of a partial hydatidiform mole and coexisting fetus during the second trimester: A case report

2015

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“…Twin pregnancies with a molar pregnancy and co-existing viable fetus have been described (4,(11)(12)(13). The majority of pregnancies were terminated once the diagnosis was made.…”

Section: Discussionmentioning

confidence: 99%

Partial hydatidiform mole progression into invasive mole with lung metastasis following in vitro fertilization

Zhou

Yong-li

et al. 2011

Oncology Letters

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Abstract. In the present study, the case of a 34-year-old Chinese female who underwent in vitro fertilization resulting in a twin pregnancy was reported. Following in vitro fertilization, the patient was found to have a partial hydatidiform mole (PHM) with a co-existing twin by transvaginal sonography (TVS). At 16 weeks, the pregnancy was terminated and a normallooking fetus with a HM placenta was delivered, in addition to a normal fetus with a normal placenta. Following termination of the pregnancy, the PHM progressed into an invasive mole with lung metastasis, a rare event. Serum human chorionic gonadotrophin (hCG) concentrations decreased in the first week following delivery, but over the following 21 days hCG levels showed a continuous increase. Following 2 cycles of combinative chemotherapy consisting of fluorouracil (5-FU) and dactinomycin (KSM), hCG concentrations decreased to normal levels. The patient was then administered 1 cycle of repeated chemotherapy and hCG levels remained negative for the following 2 years. IntroductionGestational trophoblastic disease (GTD) is known to be associated with increased maternal age and is more commonly observed in Asia. GTD has been subdivided into partial hydatidiform mole (PHM) with a fetal pole, often with triploidy, which refers to the combination of a fetus with localized hydatidiform placenta, and complete HM (CHM) without fetal tissue, which is typically diploid but derived entirely from the paternal genome (1). CHM pregnancy is more common than PHM (1). A few cases of CHM with twin pregnancy have been reported (2-4), with certain couples choosing to continue the pregnancy until 28 weeks of gestation and deliver by Caesarean section, resulting in some healthy babies (2-4). In this study, we present the first reported case of a patient who was found to have PHM with a co-existing twin following in vitro fertilization, resulting in an invasive mole that progressed and metastasized to the lung. Case reportThis study was approved by the Medical Ethics Committee of Hubei University of Medicine. The patient provided informed written consent. A 34-year-old, gravida 2, para 1, patient was known to have pelvic inflammatory disease. The patient's first pregnancy was a healthy girl delivered when the patient was 20 years old. The patient then divorced at 24 and remarried at 27. The patient's husband also had a healthy girl from his first marriage. No pregnancy occurred in the first 5 years of marriage, even though the couple were not using any contraceptive methods. The patient was then referred for assisted conception after she was diagnosed with blockage of the fallopian tubes. Following ovarian suppression with a gonadotropin-releasing hormone (GnRH) analogue, follicular growth was stimulated using purified Gn and ovulation was induced with human chorionic gonadotropin (hCG). Six oocytes were retrieved under transvaginal ultrasound guidance and these oocytes were then inseminated with spermatozoa at a concentration of 25,000 motile spermatozoa per oocyte. Fertilizatio...

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Termination of a partial hydatidiform mole and coexisting fetus: A case report

Zhang

2019

WJCC

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BACKGROUNDWe describe the treatment strategy for a patient who was found to have a partial hydatidiform mole and coexisting fetus (PHMCF) during the second trimester. The patient was a 38-year-old Chinese woman who had become pregnant following in vitro fertilization and embryo transplantation. We wanted to determine the safest therapeutic strategy to terminate the PHMCF during the second trimester.CASE SUMMARYIn this case, we present a patient who was found to have a PHMCF complicated with serious continuous vaginal bleeding and pre-eclampsia during the second trimester. After careful evaluation, the pregnancy was considered to be unsustainable and was terminated via caesarean section (CS). An infant with weak vital signs and a partially cystic placenta measuring 110 mm × 95 mm × 35 mm were delivered by CS. The patient was discharged after 4 d. The serum levels of β-human chorionic gonadotropin decreased to within a normal range 5 wk after the operation, and no evidence of persistent trophoblastic disease or lung metastases was noticed at the 6-mo follow-up.CONCLUSIONCS termination of PHMCF during the second trimester may be a relatively safe therapeutic strategy.

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Triplet pregnancy with partial hydatidiform mole coexisting with two fetuses: A case report

Cited by 9 publications

References 17 publications

Medical termination of a partial hydatidiform mole and coexisting fetus during the second trimester: A case report

Medical termination of a partial hydatidiform mole and coexisting fetus during the second trimester: A case report

Partial hydatidiform mole progression into invasive mole with lung metastasis following in vitro fertilization

Termination of a partial hydatidiform mole and coexisting fetus: A case report

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