Twin pregnancy of hydatidiform mole and viable fetus: a late diagnosis - case report / Gestação gemelar de mola hidatiforme e feto viável: um diagnóstico tardio - relato de caso

Abstract

Twin pregnancy with hydatidiform mole and viable fetus is a rare event, evolving, in most cases, to abortion or medical interruption due the associated risks. Prenatal diagnosis allows individualized, rigorous and specialized monitoring, favoring the early identification of complications. We report, based on information obtained through medical record review, interviews with patient and professionals involved and literature review, a case of twin pregnancy with hydatidiform mole and healthy newborn diagnosed at delivery. Although the uncomplicated outcome that was presented suggests the possibility of expectant conduct, it is important to recognize the rarity of the case and the associated risks, both during pregnancy, after uterine emptying and in future pregnancies, and a follow-up after molar pregnancy is essential, which is interrupted approximately half of the patients. Adherence to follow-up is favored by the correct guidance to pregnant women, and prenatal diagnosis is fundamental for ensuring better doctor-patient dialogue. Therefore, it is important to highlight that, in order to properly manage hydatidiform mole pregnancies, due attention should be paid to the early diagnosis.

Complete molar pregnancy with coexisting normal twin complicated by hyperthyroidism that resulted in normal alive delivery: A case report from Wolaita Sodo, Ethiopia

“…The coexistence of an alive fetus and molar gestation can occur in four different types pregnancy: the first type is dizygotic twins with normal fetuses and complete hydatidiform moles (diploid with a normal placenta); the second type is dizygotic twins with normal fetuses and partial hydatidiform moles; the third type is single pregnancy with a triploid fetus and partial hydatidiform; and the fourth occurrence is twin gestation in which one fetus is normal diploid with the normal placenta and the other is triploid with the partial hydatidiform molar placenta. 6,7…”

“…5 The coexistence of an alive fetus and molar gestation can occur in four different types pregnancy: the first type is dizygotic twins with normal fetuses and complete hydatidiform moles (diploid with a normal placenta); the second type is dizygotic twins with normal fetuses and partial hydatidiform moles; the third type is single pregnancy with a triploid fetus and partial hydatidiform; and the fourth occurrence is twin gestation in which one fetus is normal diploid with the normal placenta and the other is triploid with the partial hydatidiform molar placenta. 6,7 Compared to singleton or non-molar twin pregnancies, there is a higher risk of maternal complications in twin pregnancies with a complete hydatidiform mole. 8,9 These include fetal complications such as spontaneous abortion, intrauterine growth restriction, and intrauterine fetal death, as well as obstetrical complications such as hyperemesis gravidarum, antepartum hemorrhage, early-onset preeclampsia or eclampsia, hyperthyroidism, preterm premature rupture of the membranes, and preterm labor.…”