Trizygotic pregnancy consisting of two fetuses and a complete hydatidiform mole with dispermic androgenesis

Abstract

A triplet pregnancy in a 23-year-old woman was terminated at 15 weeks of gestation because of her severe hypertension, lung edema, and secondary hyperthyroidism. The pregnancy consisted of a hydatidiform mole with a 46,XY karyotype and two fetuses each with 46,XX and a 46,XY karyotype. To determine the zygosity and genetic origin of the mole and fetuses, PCR- and computer-assisted genotyping were performed at 27 CA-repeat marker loci that were distributed evenly over the genome. As a result, genotypes of the three pregnancy products were distinct from each other, indicating that the triplets were trizygotic. The mole lacked any maternal alleles but inherited both of the paternal alleles and/or one paternal allele in duplicate. This, along with the XY sex chromosome constitution, indicated that the mole resulted from dispermic androgenesis. The mother developed a persistent trophoblastic tumor thereafter.

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

“…Including this report, 14 cases of triplet or quadruplet pregnancy with a complete hydatidiform mole have been reported as shown in Table 2 1–13 . Among them, 11 cases (79%) were treated with clomiphene citrate or hMG for infertility or ovarian dysfunction.…”

“…To date, only 13 cases have been reported 1–13 . Among them, 10 cases (77%) were identified as a complication of therapy for infertility such as an ovulation induction using clomiphene citrate and/or hMG‐hCG, 1–3,5 , 7,9 , 10,12 gamete intra‐fallopian transfer (GIFT) 4 and in vitro fertilization–embryo transfer (IVF‐ET) 2 . When the diagnosis of CHM‐TCF has been made during pregnancies that were achieved after difficult and intensive infertility therapy, the patients and clinicians face serious dilemmas between immediate termination and the continuation of pregnancy because of the lack of information on the natural history and prognosis for such a condition.…”

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

“…Triplet pregnancy with a coexisting mole is extremely rare 2–8 . Multiple conceptions involving hydatidiform mole with two or more fetuses are extremely rare but are likely to occur more frequently with the increasing number of multiple births in couples undergoing treatment for infertility 5 …”

“…Yet this is likely to more frequently occur with the increasing number of multiple births due to couples undergoing treatment for infertility. There have been several reports of a triplet pregnancy with a complete hydatidiform mole coexisting with two fetuses (CHMCF) 2–8 . However, to our knowledge, there was no report of triplet pregnancy with partial hydatidiform mole and a coexistent fetus (PHMCF).…”

Complete Hydatidiform Mole in a Triplet Pregnancy With Coexisting Two Live Foetuses- A Case Report and Review of Literature

“…Shozu et al (11) IVF -ET 15 0 Vaginal bleeding, persistent trophoblastic tumour 7. Higashino et al (12) Clomiphene + FSH + hCG 15 0 Preeclampsia, secondary hyperthyroidism, persistent trophoblastic tumour 8. Amr et al (13) Clomiphene + hCG 30 1 None 9.…”