Complete Hydatidiform Mole with Co-existing Live Fetus: A Case Series

Abstract

Abstract This review was undertaken to evaluate the maternal and fetal risk associated with complete hydatidiform mole with co-existing fetus (CHMF) and to assess the feasibility for continuing such pregnancies. Twin gestations with CHMF were reviewed from the hospital database from 2005 to 2014 at our center. Diagnosis was based on ultrasonography and confirmed post-delivery, histopathologically. Amniocentesis for karyotype was done for the live fetuses. Serum β-hCG levels were followed till they normalized. Six cases of CHMF were salvaged from the archives. Three had live normal babies (50 %), pregnancy was terminated in two cases for excessive bleeding (33.3 %) and one miscarried (16.7 %). One fetus exhibited 47, XXY Klinefelter syndrome while rest showed normal karyotype. Two patients required blood transfusion, one was complicated with severe pre-eclampsia whereas none showed gestational trophoblastic neoplasm. CHMF is a rare condition that can be diagnosed by ultrasonography. Continuation of such a pregnancy is an acceptable option and expectant management instead of therapeutic abortion can be pursued after weighing the possibility of fetal survival against maternal risk. Counseling of the couple and family plays a crucial role. Associated spectrum of maternal and fetal complications mandates close pre- and post-natal surveillance.