Complete hydatidiform mole with coexistent fetus

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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.

Epidemiology

It is seen extremely rarely, with an estimated incidence of one in 22,000–100,000 pregnancies.

Clinical features

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.

Radiographic features

Ultrasound

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 a termination of pregnancy is suggested by a large number of studies. Some suggest that after confirmation of normal karyotype in the coexistent foetus and appropriate patient counselling, continuation of pregnancy can be attempted despite a 30% risk of bleeding and preeclampsia.

Differential diagnosis

partial molar pregnancy

placental mesenchymal dysplasia

-<p><strong>Complete hydatidiform mole with coexistant fetus (CHMCF) </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. Uterus is larger than the period of gestation and abnormally high levels of hCG. Clinical problems include vaginal bleeding, toxemia, and excessive vomiting.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Sonological findings of a complete hydatidiform mole, such as a snowstorm appearance is 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, intrauterine fetal death, bleeding, preeclampsia and persistent trophoblastic disease (PTD). </p><p>Considering the maternal complication a termination of pregnancy is suggested by a large number of studies. Some suggest that after confirmation of normal karyotype in the coexistent foetus and appropriate patient counselling, continuation of pregnancy can be attempted despite a 30% risk of bleeding and preeclampsia. </p><p><strong>Differential diagnosis</strong></p><ul><li><a title="Partial molar pregnancy" href="/articles/partial-hydatidiform-mole">partial molar pregnancy</a></li></ul>
+<p><strong>Complete hydatidiform mole with coexistant fetus (CHMCF) </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. Uterus is larger than the period of gestation and abnormally high levels of hCG. Clinical problems include vaginal bleeding, toxemia, and excessive vomiting.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Sonological findings of a complete hydatidiform mole, such as a snowstorm appearance is 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, intrauterine fetal death, bleeding, preeclampsia and persistent trophoblastic disease (PTD). </p><p>Considering the maternal complication a termination of pregnancy is suggested by a large number of studies. Some suggest that after confirmation of normal karyotype in the coexistent foetus and appropriate patient counselling, continuation of pregnancy can be attempted despite a 30% risk of bleeding and preeclampsia. </p><p><strong>Differential diagnosis</strong></p><ul>
+<li><a href="/articles/partial-hydatidiform-mole">partial molar pregnancy</a></li>
+<li><a title="Placental mesenchymal dysplasia" href="/articles/placental-mesenchymal-dysplasia">placental mesenchymal dysplasia</a></li>
+</ul>

References changed:

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. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22838245">Pubmed</a>
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. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671816">PMC3671816</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23741539">Pubmed</a>
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. <a href="https://doi.org/10.5812/iranjradiol.4488">doi:10.5812/iranjradiol.4488</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23329950">Pubmed</a>
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. <a href="https://doi.org/10.1186/1752-1947-6-95">doi:10.1186/1752-1947-6-95</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22472309">Pubmed</a>

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