Complete hydatidiform mole with coexistent fetus
Updates to Article Attributes
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.
Epidemiology
It is seen extremely rarely, with an estimated incidence of 1 in 10,000–100,000 pregnancies 5.
Clinical presentation
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.
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 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 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 there is a <a href="/articles/twin-pregnancy-1" title="Twin pregnancy">twin pregnancy</a> with a <a href="/articles/complete-hydatidiform-mole" title="Complete hydatidiform mole">complete hydatidiform mole</a> and a normal fetus. </p><h4>Epidemiology</h4><p>It is seen extremely rarely, with an estimated incidence of 1 in 10,000–100,000 pregnancies <sup>5</sup>.</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 <a href="/articles/beta-hcg-1" title="Beta-hCG">beta-hCG</a>. 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 complications such as spontaneous abortion, preterm delivery, <a href="/articles/fetal-death-in-utero-1">intrauterine fetal death</a>, bleeding, <a href="/articles/pre-eclampsia" title="Pre-eclampsia">pre-eclampsia</a> and persistent trophoblastic disease. </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 there is a <a href="/articles/twin-pregnancy-1" title="Twin pregnancy">twin pregnancy</a> with a <a href="/articles/complete-hydatidiform-mole" title="Complete hydatidiform mole">complete hydatidiform mole</a> and a normal fetus. </p><h4>Epidemiology</h4><p>It is seen extremely rarely, with an estimated incidence of 1 in 10,000–100,000 pregnancies <sup>5</sup>.</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 <a href="/articles/beta-hcg-1" title="Beta-hCG">beta-hCG</a>. 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 complications such as spontaneous abortion, preterm delivery, <a href="/articles/fetal-death-in-utero-1">intrauterine fetal death</a>, bleeding, <a href="/articles/pre-eclampsia" title="Pre-eclampsia">pre-eclampsia</a> and persistent trophoblastic disease. </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>
Image 4 Ultrasound (Transverse) ( create )
Unable to process the form. Check for errors and try again.