Citation, DOI, disclosures and article data
Citation:
Skandhan A, Najjar R, Fayisa S, et al. Complete hydatidiform mole with coexistent fetus. Reference article, Radiopaedia.org (Accessed on 23 Feb 2025) https://doi.org/10.53347/rID-40042
Complete hydatidiform mole with coexistent fetus is an extremely rare entity where there is a twin pregnancy with a complete hydatidiform mole and a normal fetus.
It is seen extremely rarely, with an estimated incidence of 1 in 10,000–100,000 pregnancies 5.
Exaggerated signs and symptoms of pregnancy may be evident. The uterus is larger than the period of gestation and has abnormally high levels of beta-hCG. Clinical presentations include vaginal bleeding, preeclampsia and excessive vomiting.
Ultrasound
Sonographic findings of a complete hydatidiform mole, such as a snowstorm appearance are seen with a completely normal fetus with a normal placenta.
Treatment and prognosis
These cases are at high risk of complications such as spontaneous abortion, preterm delivery, intrauterine fetal death, bleeding, pre-eclampsia and persistent trophoblastic disease.
Considering the maternal complication, termination of pregnancy is suggested by a large number of studies. Some suggest that after confirmation of normal karyotype in the coexistent fetus and appropriate patient counseling, continuation of pregnancy can be attempted despite a 30% risk of bleeding and preeclampsia.
Possible differential considerations include
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1. Sasaki Y, Ogawa K, Takahashi J, Okai T. Complete Hydatidiform Mole Coexisting with a Normal Fetus Delivered at 33 Weeks of Gestation and Involving Maternal Lung Metastasis: A Case Report. J Reprod Med. 2012;57(7-8):301-4. - Pubmed
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2. Vimercati A, de Gennaro A, Cobuzzi I et al. Two Cases of Complete Hydatidiform Mole and Coexistent Live Fetus. J Prenat Med. 2013;7(1):1-4. PMC3671816 - Pubmed
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3. Moini A, Ahmadi F, Eslami B, Zafarani F. Dizygotic Twin Pregnancy with a Complete Hydatidiform Mole and a Coexisting Viable Fetus. Iran J Radiol. 2011;8(4):249-52. doi:10.5812/iranjradiol.4488 - Pubmed
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4. Shazly S, Ali M, Abdel Badee A, Alsokkary A, Khodary M, Mostafa N. Twin Pregnancy with Complete Hydatidiform Mole and Coexisting Fetus Following Ovulation Induction with a Non-Prescribed Clomiphene Citrate Regimen: A Case Report. J Med Case Rep. 2012;6(1):95. doi:10.1186/1752-1947-6-95 - Pubmed
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5. Chen FP. Molar pregnancy and living normal fetus coexisting until term: prenatal biochemical and sonographic diagnosis. Hum. Reprod. 1997;12 (4): 853-6. doi:10.1093/humrep/12.4.853 - Pubmed citation
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6. Monga M, Schumacher V, Wicklund CA et-al. Ultrasound diagnosis of coexisting molar pregnancy following referral for abnormal serum screen. Am J Perinatol. 2005;22 (1): 53-5. doi:10.1055/s-2004-837270 - Pubmed citation
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