Prenatal diagnosis and management of pregnancy complicated by a coexisting mole: A case report

Twin pregnancies with a complete hydatidiform mole and a coexisting live fetus are rare. The incidence is estimated to be 1 in 20,000-100,000 pregnancies. Prenatal diagnosis can be made with ultrasound findings, abnormally elevated β-hCG levels, and fetal karyotype. There are various complications following these pregnancies which include hyperemesis gravidarum, vaginal bleeding, spontaneous abortion, pre-eclampsia, intrauterine growth retardation, preterm delivery, and persistent trophoblastic disease. We report an interesting case of twin pregnancy consisting of a complete hydatidiform mole and a normal fetus achieved with in-vitro fertilization in a primary infertile couple. Suspicion of molar pregnancy was made on ultrasound examination, but the couple refused other prenatal testing and wanted to continue the pregnancy. Although the pregnancy was at high risk because of the patient's age and complications associated with a molar pregnancy, a vigorous female baby was delivered at term. The purpose of this report is to present a case of a rare obstetric condition, give evidence that gestational trophoblastic disease is occurring more commonly in multiple gestations and in-vitro fertilization pregnancies, and highlight the importance of ultrasound in prenatal diagnostics and monitoring of high-risk pregnancies.