Complete hydatidiform mole with coexistent fetus
Updates to Article Attributes
Complete hydatidiform mole with coexistent fetus is an extremely rare entity where as the name suggests there is a twin pregnancy with a complete hydatidiform mole and a normal fetus.
Epidemiology
It is seen extremely rarely, with an estimated incidence of one in 22,000–100,000 pregnancies.
Clinical featurespresentation
Exaggerated signs and symptoms of pregnancy may be evident. The uterus is larger than the period of gestation and has abnormally high levels of hCG. Clinical problemspresentations include vaginal bleeding, toxaemiapreeclampsia and excessive vomiting.
Radiographic features
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 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.
Differential diagnosis
Possible differential considerations include
Breus mole (massive subchorionic haemorrhage)
-<p><strong>Complete hydatidiform mole with coexistent fetus</strong> is an extremely rare entity where as the name suggests there is a twin pregnancy with a complete hydatidiform mole and a normal fetus. </p><h4>Epidemiology</h4><p>It is seen extremely rarely, with an estimated incidence of one in 22,000–100,000 pregnancies.</p><h4>Clinical features</h4><p>Exaggerated signs and symptoms of pregnancy may be evident. The uterus is larger than the period of gestation and has abnormally high levels of hCG. Clinical problems include vaginal bleeding, toxaemia and excessive vomiting.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Sonographic findings of a complete hydatidiform mole, such as a snowstorm appearance are seen with a completely normal fetus with a normal placenta.</p><h4>Treatment and prognosis</h4><p>These cases are at high risk of spontaneous abortion, preterm delivery, <a href="/articles/fetal-death-in-utero-1">intrauterine fetal death</a>, bleeding, preeclampsia and persistent trophoblastic disease (PTD). </p><p>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. </p><h4>Differential diagnosis</h4><p>Possible differential considerations include</p><ul>-<li><p><a href="/articles/partial-hydatidiform-mole">partial molar pregnancy</a></p></li>-<li><p><a href="/articles/breus-mole" title="Breus mole">Breus mole</a> (massive subchorionic haemorrhage)</p></li>-<li><p><a href="/articles/placental-mesenchymal-dysplasia">placental mesenchymal dysplasia</a></p></li>- +<p><strong>Complete hydatidiform mole with coexistent fetus</strong> is an extremely rare entity where as the name suggests there is a twin pregnancy with a complete hydatidiform mole and a normal fetus. </p><h4>Epidemiology</h4><p>It is seen extremely rarely, with an estimated incidence of one in 22,000–100,000 pregnancies.</p><h4>Clinical presentation</h4><p>Exaggerated signs and symptoms of pregnancy may be evident. The uterus is larger than the period of gestation and has abnormally high levels of hCG. Clinical presentations include vaginal bleeding, preeclampsia and excessive vomiting.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Sonographic findings of a complete hydatidiform mole, such as a snowstorm appearance are seen with a completely normal fetus with a normal placenta.</p><h4>Treatment and prognosis</h4><p>These cases are at high risk of spontaneous abortion, preterm delivery, <a href="/articles/fetal-death-in-utero-1">intrauterine fetal death</a>, bleeding, preeclampsia and persistent trophoblastic disease (PTD). </p><p>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. </p><h4>Differential diagnosis</h4><p>Possible differential considerations include</p><ul>
- +<li><p><a href="/articles/partial-hydatidiform-mole">partial molar pregnancy</a></p></li>
- +<li><p><a href="/articles/breus-mole" title="Breus mole">Breus mole</a> (massive subchorionic haemorrhage)</p></li>
- +<li><p><a href="/articles/placental-mesenchymal-dysplasia">placental mesenchymal dysplasia</a></p></li>