Living Newborn Back-To-Back With a Complete Hydatidiform Mole: A Rare Twin Pregnancy Outcome

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Endocrinology

Background:

• Complete hydatidiform mole (CHM) in twin pregnancies presents unique management challenges.
• Existing guidelines for CHM management do not adequately address co-occurrence with a viable fetus.
• Balancing maternal risks with potential fetal survival is a critical clinical dilemma.

Purpose of the Study:

• To report a case of successful pregnancy management with coexisting complete hydatidiform mole and a healthy fetus.
• To discuss the diagnostic and management strategies for this rare obstetric complication.
• To highlight the importance of individualized patient counseling and close monitoring.

Main Methods:

• Case report of a 20-year-old woman diagnosed with CHM and a coexisting fetus at 18 weeks gestation.
• Serial ultrasound monitoring and close clinical follow-up throughout the pregnancy.
• Management decisions based on rigorous counseling regarding risks of obstetrical complications and gestational trophoblastic neoplasia (GTN).

Main Results:

• The pregnancy was managed conservatively after the patient declined termination.
• The pregnancy progressed without major obstetrical complications.
• An uncomplicated delivery via cesarean section was achieved at 34 weeks gestation.

Conclusions:

• Successful management of twin pregnancy with CHM and a healthy fetus is possible with meticulous monitoring and individualized care.
• Patient counseling regarding significant risks, including GTN, is paramount.
• This case underscores the need for further research and potential guideline development for CHM in twin gestations.