Complete hydatidiform mole with coexistant fetus
Complete hydatidiform mole with coexistant fetus (CHMCF) is an extremely rare entity where as the name suggests there is a twin pregnancy with a complete hydatidiform mole and a normal fetus.
It is seen extremely rarely, with an estimated incidence of one in 22,000–100,000 pregnancies.
Exaggerated signs and symptoms of pregnancy may be evident. Uterus is larger than the period of gestation and abnormally high levels of hCG. Clinical problems include vaginal bleeding, toxemia and excessive vomiting.
Sonological findings of a complete hydatidiform mole, such as a snowstorm appearance is seen with a completely normal fetus with a normal placenta.
Treatment and prognosis
These cases are at high risk of spontaneous abortion, preterm delivery, intrauterine fetal death, bleeding, preeclampsia and persistent trophoblastic disease (PTD).
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 counselling, continuation of pregnancy can be attempted despite a 30% risk of bleeding and preeclampsia.
Possible differential considerations include
- 1. Sasaki Y, Ogawa K, Takahashi J et-al. 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 citation
- 2. Vimercati A, de Gennaro AC, Cobuzzi I et-al. Two cases of complete hydatidiform mole and coexistent live fetus. J Prenat Med. 2013;7 (1): 1-4. Free text at pubmed - Pubmed citation
- 3. Moini A, Ahmadi F, Eslami B et-al. 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 - Free text at pubmed - Pubmed citation
- 4. Shazly SA, Ali MK, Abdel Badee AY et-al. 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.6 (1): 95. doi:10.1186/1752-1947-6-95 - Free text at pubmed - Pubmed citation