Archives of Gynecology and Obstetrics

, Volume 279, Issue 3, pp 431–436

Twin pregnancy with a complete hydatidiform mole and co-existent live fetus: two case reports and review of the literature

  • Kenan Dolapcioglu
  • Arif Gungoren
  • Sibel Hakverdi
  • Ali Ulvi Hakverdi
  • Ertugrul Egilmez
Case Report

Abstract

Introduction

The aim of this study was to report the clinical features, management, and outcome of two cases of complete hydatidiform mole with a coexisting viable fetus and to review the literature.

Case reports

In this article, we report on the well-documented follow-up of two cases of twin pregnancies with complete hydatidiform mole and a normal fetus. Genetic amniocentesis showed normal fetal karyotype in both of two cases. In the first case, a live male infant was delivered by a cesarean section because of severe maternal bleeding at 29 weeks of gestation. In the second case, termination of pregnancy was performed due to early onset of severe preeclampsia and vaginal hemorrhage.

Conclusion

The chances of a live birth have been estimated between 30 and 35% and the risk of persistent trophoblastic disease is similar to singleton molar pregnancies in complete mole with coexisting fetus pregnancy. Therefore, in these pregnancies, expectant management instead of termination of pregnancy can be suggested.

Keywords

Gestational trophoblastic disease Hydatidiform mole Twin pregnancy 

References

  1. 1.
    Suzuki M, Matsunobu A, Wakita K, Nishijima M, Osanai K (1980) Hydatidiform mole with a surviving coexisting fetus. Obstet Gynecol 56:384–388PubMedGoogle Scholar
  2. 2.
    Vaisbuch E, Ben-Arie A, Dgani R, Perlman S, Sokolovsky N, Hagay Z (2006) Twin pregnancy consisting of a complete hydatidiform mole and co-existent fetus: report of two cases and review of literature. Gynecol Oncol 100:218–219. doi:10.1016/j.ygyno.2005.09.003 CrossRefGoogle Scholar
  3. 3.
    Bristow RE, Shumway JB, Khouzami AN, Witter FR (1996) Complete hydatidiform mole and surviving coexistent twin. Obstet Gynecol Surv 51:705–709. doi:10.1097/00006254-199612000-00002 PubMedCrossRefGoogle Scholar
  4. 4.
    Steller MA, Genest DR, Bernstein MR, Lage JM, Goldstein DP, Berkowitz RS (1994) Clinical features of multiple conception with partial or complete molar pregnancy and coexisting fetuses. J Reprod Med 39:147–154PubMedGoogle Scholar
  5. 5.
    Vejerslev LO, Sunde L, Hansen BF, Larsen JK, Christensen IJ, Larsen G (1991) Hydatidiform mole and fetus with normal karyotype: support of a separate entity. Obstet Gynecol 77:868–874PubMedGoogle Scholar
  6. 6.
    Fishman DA, Padilla LA, Keh P, Cohen L, Frederiksen M, Lurain JR (1998) Management of twin pregnancies consisting of a complete hydatidiform mole and normal fetus. Obstet Gynecol 91:546–550. doi:10.1016/S0029-7844(97)00720-5 PubMedCrossRefGoogle Scholar
  7. 7.
    Garbin O, Favre R, Weber P, Arbogast E, Gasser B (1995) How to deal with a rare entity: the coexistence of a complete mole and a healthy egg in twin pregnancy? Fetal Diagn Ther 10:337–342PubMedCrossRefGoogle Scholar
  8. 8.
    Ishii J, Iitsuka Y, Takano H, Matsui H, Osada H, Sekiya S (1998) Genetic differentiation of complete hydatidiform moles coexisting with normal fetuses by short tandem repeat derived deoxyribonucleic acid polymorphism analysis. Am J Obstet Gynecol 179:628–634. doi:10.1016/S0002-9378(98)70055-9 PubMedCrossRefGoogle Scholar
  9. 9.
    Marcorelles P, Audrezet MP, Le Bris MJ, Laurent Y, Chabaud JJ, Ferec C et al (2005) Diagnosis and outcome of complete hydatidiform mole coexisting with a live twin fetus. Eur J Obstet Gynecol Reprod Biol 118:21–27. doi:10.1016/j.ejogrb.2004.02.042 PubMedCrossRefGoogle Scholar
  10. 10.
    Sebire NJ, Foskett M, Paradinas FJ, Fisher RA, Francis RJ, Short D et al (2002) Outcome of twin pregnancies with complete hydatidiform mole and healthy co-twin. Lancet 359:2165–2166. doi:10.1016/S0140-6736(02)09085-2 PubMedCrossRefGoogle Scholar
  11. 11.
    Niemann I, Sunde L, Peterson LK (2007) Evaluation of the risk of persistent trophoblastic disease after twin pregnancy with diploid hydatidiform mole and coexisting normal fetus. Am J Obstet Gynecol 197:451–455CrossRefGoogle Scholar
  12. 12.
    Matsui H, Sekiya S, Hando T, Wake N, Tomoda Y (2000) Hydatidiform mole coexistent with a twin live fetus: a national collaborative study in Japan. Hum Reprod 15:608–611. doi:10.1093/humrep/15.3.608 PubMedCrossRefGoogle Scholar
  13. 13.
    Sebire NJ (2006) Prenatal diagnosis and management of twin pregnancies complicated by a co-existing molar pregnancy. Prenat Diagn 26(4):373. doi:10.1002/pd.1380 PubMedCrossRefGoogle Scholar
  14. 14.
    Shahabi S, Naome G, Cobin L, Veroughstruele A, Musters L, Zengbe V et al (1977) Complete hydatidiform mole and coexisting fetus. A case report of two cases with contrasting outcomes. J Reprod Med 42:756–760Google Scholar
  15. 15.
    Block MF, Merill JA (1982) Hydatidifrom mole with coexistent fetus. Obstet Gynecol 60:129–134PubMedGoogle Scholar
  16. 16.
    Miller D, Jackson R, Ehlen T, McMurtie E (1993) Complete hydatidiform mole coexistent with a twin live fetus. Clinical course of four cases with complete cytogenic analysis. Gynecol Oncol 50:119–123. doi:10.1006/gyno.1993.1175 PubMedCrossRefGoogle Scholar
  17. 17.
    Jinno M, Ubukata Y, Hanya I, Satou M, Yoshimura Y, Nakamura Y (1994) Hydatidiform mole with a surviving coexistent fetus following in-vitro fertilization. Hum Reprod 9:1770–1772PubMedGoogle Scholar
  18. 18.
    Anderson CK, Deiter RWM, Motz MJ, Goldstein JA (1996) Complete hydatidiform mole with a coexistent healthy, viable fetus near term: a case report. J Reprod Med 41:55–58PubMedGoogle Scholar
  19. 19.
    Chen EP (1997) Molar pregnancy and living normal fetus coexistent until term: prenatal biochemical and sonographic diagnosis. Hum Reprod 12:853–856. doi:10.1093/humrep/12.4.853 PubMedCrossRefGoogle Scholar
  20. 20.
    Montes-de-Oca-Valero F, Macara L, Shaker A (1999) Twin pregnancy with a complete mole and co-existing fetus following in-vitro fertilization. Hum Reprod 14:2905–2907. doi:10.1093/humrep/14.11.2905 PubMedCrossRefGoogle Scholar
  21. 21.
    Abbi M, Kriplani A, Uppal R, Takkar D (1999) Term twin pregnancy with hydatidiform mole and normal fetus. Arch Gynecol Obstet 262:189–191. doi:10.1007/s004040050248 PubMedCrossRefGoogle Scholar
  22. 22.
    Amr MF, Fisher RA, Foskett MA, Paradinas FJ (2000) Triplet pregnancy with hydatidiform mole. Int J Gynecol Cancer 10:76–81. doi:10.1046/j.1525-1438.2000.99064.x PubMedCrossRefGoogle Scholar
  23. 23.
    Bruchim I, Kidron D, Amiel A, Altaras M, Fejgin MD (2000) Complete hydatidiform mole and a coexistent viable fetus: report to two cases and review of the literature. Gynecol Oncol 77:197–202. doi:10.1006/gyno.2000.5733 PubMedCrossRefGoogle Scholar
  24. 24.
    Makrydimas G, Sebire HJ, Thornton SE, Zagorianakou N, Lolis D, Fisher RA (2002) Complete hydatidiform mole and normal live birth: a novel case of conWned placental mosaicism. Hum Reprod 17:2459–2463. doi:10.1093/humrep/17.9.2459 PubMedCrossRefGoogle Scholar
  25. 25.
    Wax JR, Pinette MG, Chard R, Blackstone J, Cartin A (2003) Prenatal diagnosis by DNA polymorphism analysis of complete mole with coexisting twin. Am J Obstet Gynecol 188:1105–1106. doi:10.1067/mob.2003.151 PubMedCrossRefGoogle Scholar
  26. 26.
    Moini A, Riazi K (2003) Molar pregnancy with a coexisting fetus progressing to a viable infant. Int J Gynaecol Obstet 82:63–64. doi:10.1016/S0020-7292(03)00039-0 PubMedCrossRefGoogle Scholar
  27. 27.
    Bovicelli L, Ghi T, Pilu G, Farina A, Savelli L, Simonazzi G et al (2004) Prenatal diagnosis of a complete mole coexisting with a dichorionic twin pregnancy: case report. Hum Reprod 19:1231–1234. doi:10.1093/humrep/deh211 PubMedCrossRefGoogle Scholar
  28. 28.
    Hyodo M, Samura O, Miharu N, Ohama K, Kudo Y (2005) Molar DNA in maternal serum in a case of 46, XY heterozygous complete hydatidiform mole coexisting with a 46, XX twin live fetus. Clin Chem 51:676–677. doi:10.1373/clinchem.2004.043034 PubMedCrossRefGoogle Scholar
  29. 29.
    Lambert-Messerlian G, Pinar H, Rubin LP, De Paepe ME, Tantravahi U, Steinhoff MM et al (2005) Second-trimester maternal serum markers in twin pregnancy with complete mole: report of 2 cases. Pediatr Dev Pathol 8:230–234. doi:10.1007/s10024-005-0121-9 PubMedCrossRefGoogle Scholar
  30. 30.
    Hamanoue H, Umezu N, Okuda M, Harada N, Ohata T, Sakai H et al (2006) Complete hydatidiform mole and normal live birth following intracytoplasmic sperm injection. J Hum Genet 51:477–479. doi:10.1007/s10038-006-0388-3 PubMedCrossRefGoogle Scholar
  31. 31.
    Klatt TE, Franciosi RA, Cruikshank DP (2006) Normal fetus with a twin presenting as both a complete hydatidiform mole and placenta previa. Obstet Gynecol 107:527–530PubMedGoogle Scholar
  32. 32.
    Piura B, Rabinovich A, Hershkovitz R, Maor E, Mazor M (2008) Twin pregnancy with a complete hydatidiform mole and surviving co-existent fetus. Arch Gynecol Obstet. 2008 Feb 14. [Epub ahead of print]Google Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Kenan Dolapcioglu
    • 1
    • 4
  • Arif Gungoren
    • 1
  • Sibel Hakverdi
    • 2
  • Ali Ulvi Hakverdi
    • 1
  • Ertugrul Egilmez
    • 3
  1. 1.Department of Obstetrics and Gynecology, Faculty of MedicineMustafa Kemal UniversityAntakyaTurkey
  2. 2.Department of Pathology, Faculty of MedicineMustafa Kemal UniversityAntakyaTurkey
  3. 3.Department of Radiology, Faculty of MedicineMustafa Kemal UniversityAntakyaTurkey
  4. 4.MKU Arastirma HastanesiAntakyaTurkey

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