A complete hydatidiform mole and coexisting viable fetus in a twin pregnancy: a case report with literature review

Abstract

Introduction

A twin pregnancy involving a hydatidiform mole (HM) coexisting with a developing fetus is an extremely rare obstetric complication, which typically presents as a complete hydatidiform mole with a coexisting fetus (CHMCF) or a partial hydatidiform mole with a coexisting fetus (PHMCF).

Case presentation

A 26-year-old woman was admitted to our hospital due to a small volume of vaginal bleeding during the 31st week of pregnancy. The patient was previously healthy, and an intrauterine singleton pregnancy was detected by ultrasound on day 46 of gestation; however, bunch-of-grapes sign was observed in the uterine cavity at 24 weeks. The patient was subsequently diagnosed with CHMCF. As the patient insisted on continuing her pregnancy, she underwent hospital monitoring. Vaginal bleeding occurred in the 33rd week again and received a course of betamethasone, then continued pregnancy after bleeding stopped spontaneously. In the 37th week, a male infant weighing 3090 g was delivered by cesarean section, with an Apgar score of 10 at 1 min and a karyotype of 46XY. Placental pathology confirmed the diagnosis of a complete hydatid tumor.

Conclusion

In this report, a case of CHMCF was maintained by monitoring of blood pressure, thyroid function, human chorionic gonadotrophin, and fetal condition during pregnancy. A live newborn was delivered by cesarean section. CHMCF is a clinically rare disease with high risks; thus, it should be diagnosed carefully using several tools, including ultrasound, magnetic resonance imaging, and karyotype analysis and dynamically monitored if the patient decides to continue the pregnancy.

Keywords:

• Twin
• case report
• complete hydatidiform mole with a coexisting fetus
• hydatidiform mole and coexisting fetus
• coexisting fetus

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author Contributions

GW: Guarantor of integrity of the entire study and contributor to the study concepts, study design, definition of intellectual content, data analysis, statistical analysis, manuscript editing, and manuscript review. HYC: Literature review, clinical studies, experimental studies, data acquisition, and manuscript preparation. XC: literature research, experimental studies, data acquisition, and manuscript preparation. All authors read and approved the final manuscript.

Data availability Statement

All data analyzed during this study are included in the published article.

Additional information

Funding

This study was supported by the Science and Technology Popularization Project of Tianjin Municipal Science and Technology Bureau [21KPHDRC00120]. The funder had no role in the conduct of the study.