Complete mole coexistent with a twin fetus

Complete hydatiforme mole with coexisting live fetus (CMCF) is a rare entity. Management for this rare twin pregnancy still remains undetermined. We report the delivery of a healthy baby coexisting with complete mole as twins. There was no other complication during or after the pregnancy.

A 30-year-old multiparous woman was first time assessed in the antenatal outpatient department of our hospital at 17 weeks gestation for normal pregnancy control. Ultrasound examination showed a 17 week and 5 days viable fetus with normal anatomy and placenta. There was a second multicystic placenta located at the posterior wall of the uterus next to the normal placenta. Hydatiforme mole was suspected. The couple was informed about the possible complications but they were not willing to consider pregnancy termination or to have any invasive procedure for diagnosis. A cesarean section was performed at 33 weeks gestation due to premature rupture of membranes and initiation of labor with the fetus presenting as breech. After the delivery of a live healthy female 1,950 g baby, as well as the normal placenta, a second vesicular placenta was delivered. Histopathologic examination confirmed the diagnosis of complete mole.

Today most of the twin pregnancies with complete mole are identified in the first or second trimester. In this case, the parents who choose continuation of pregnancy, are counseled about the increased risk of complications like preeclampsia, fetal loss, persistent gestational trophoblastic disease. Close surveillance of the woman with CMCF is mandatory during and after the pregnancy.