Coexistent Fetus Research Articles

Molar Pregnancy with a Coexistent Fetus following Assisted Reproductive Techniques: A Review of Literature of the Clinical Course and Sequelae

Abstract The clinical course and sequelae of molar pregnancy pose several diagnostic and management challenges, especially conceiving after assisted reproductive technology. A review of the literature was conducted on molar pregnancy with a coexistent fetus following assisted reproductive techniques, its clinical course, and sequelae. The literature review was conducted using search terms “coexistent fetus,” “hydatidiform mole,” “twin,” “assisted conception” AND “persistent gestational trophoblastic disease (PGTD)” OR “chemotherapy” in PubMed. A literature search identified 26 reported cases conceived following assisted conception. Management guidelines for hydatidiform mole with live fetuses are very vague and do not give specificity due to the fact that it is often associated with complications and bad obstetric outcomes. It also requires continuous monitoring and follow-up in a tertiary care center anticipating disease progression to postnatal PGTD. To assess the risk of continuation of pregnancy, multicentric studies with larger sample sizes are required to have a valid finding.

Molar pregnancy with a coexistent fetus following assisted reproductive techniques: Two case reports

Hydatidiform mole with the coexisting live fetus is a rare entity occurring in 0.005%–0.01% of all pregnancies. With the introduction of assisted reproductive techniques (ARTs), a significant rise in the incidence of multiple pregnancies has been reported. Here, we report two cases of molar pregnancies with a coexisting live fetus conceived following assisted conception. In our first case, pregnancy was continued and delivered a term live infant. The second case was aborted at 16 weeks' gestation due to maternal complications. These two patients needed chemotherapy due to persistent gestational trophoblastic disease. The rarity of this condition poses several diagnostic and management challenges, especially conceiving after ART the decision of termination for such couples.

Prenatal differential diagnosis of placental mesenchymal dysplasia and molar disease with coexistent live twin fetuses

Background: Numerous hypoechoic cysts in the placenta on prenatal ultrasonography with a live fetus may indicate twin pregnancy with a complete hydatidiform mole with a coexistent fetus, partial mole, confined placental mosaicism, or placental mesenchymal dysplasia (PMD). Ultrasonographic appearances of these are similar; however, the differential diagnosis should be made because maternal and fetal prognoses differ. Cases: We present two cases of twin pregnancies with numerous placental cystic lesions. The first case was a partial hydatidiform mole in monochorionic diamniotic twins with a diploid karyotype that underwent a spontaneous abortion at 20 gestational weeks. The second case was PMD in dichorionic diamniotic twins; live twin neonates were delivered at 34 gestational weeks. Emergency cesarean section delivery was performed due to severe preeclampsia and fetal growth restriction in twin A at 34 weeks of gestation. Conclusions: Numerous hypoechoic cysts in the placenta on prenatal ultrasonography with a normal live fetus warrants chromosomal analysis and serial ultrasonographic examination to differentiate between PMD and molar pregnancy with a coexisting normal fetus to avoid unnecessary termination.

Twin Gestation with Complete Hydatidiform Mole and Demise of Co-Existing Fetus.

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Twin pregnancy with complete hydatidiform mole: A case report

Objective: The association of twin pregnancy and a hydatidiform mole is a rare clinical condition. With the development of ultrasonography devices, prenatal diagnosis becomes easier.
 Case Report: A 21-year-old patient with gravida 1 parity 0 applied to our clinic with the complaint of vaginal bleeding at the 16th week of her pregnancy according to her last menstrual period. A pregnancy termination option was offered to the patient who was diagnosed with twin pregnancy consisting of a complete hydatidiform mole and co-existent fetus as a result of the examination and tests. Emergency laparotomy was planned for the patient who did not accept the pregnancy termination option because of severe vaginal bleeding at the 21st week of pregnancy.
 Conclusion: Although live births are reported in the literature in cases where twin pregnancy and hydatidiform mole are seen together, pregnancy termination due to vaginal bleeding may be required in earlier weeks.

Maternal pulmonary congestion and pleural effusion after termination of pregnancy at first trimester in complete hydatidiform mole with coexistent fetus

Maternal pulmonary congestion and pleural effusion after termination of pregnancy at first trimester in complete hydatidiform mole with coexistent fetus

When a vesicular placenta meets a live fetus: case report of twin pregnancy with a partial hydatidiform mole

BackgroundHydatidiform moles exhibit a distinctive gross appearance of multiple vesicles in the placenta. The advances in cytogenetic technologies have helped uncover novel entities of hydatidiform moles and enabled elaborate diagnoses. However, management of a vesicular placenta with a coexistent live fetus poses a bigger challenge beyond hydatidiform moles.Case presentationA 33-year-old woman was referred to our department for suspected hydatidiform mole coexistent with a live fetus at 24 weeks’ gestation. The patient had conceived through double embryo transplantation, and first-trimester ultrasonography displayed a single sac. Mid-trimester imaging findings of normal placenta parenchyma admixed with multiple vesicles and a single amniotic cavity with a fetus led to suspicion of a singleton partial molar pregnancy. After confirmation of a normal diploid by amniocentesis and close surveillance, the patient delivered a healthy neonate. Preliminary microscopic examination of the placenta failed to clarify the diagnosis until fluorescence in situ hybridization showed a majority of XXY sex chromosomes. The patient developed suspected choriocarcinoma and achieved remission for 5 months after chemotherapy, but relapsed with suspected intermediate trophoblastic tumor.ConclusionWe report a rare case of twin pregnancy comprising a partial mole and a normal fetus that resembled a singleton partial molar pregnancy. Individualized care is important in conditions where a vesicular placenta coexists with a fetus. We strongly recommend ancillary examinations in addition to traditional morphologic assessment in such cases.

Management of Complete Hydatidiform Mole with Co-existing Fetus

Management of Complete Hydatidiform Mole with Co-existing Fetus

OC12.01: Can ultrasound do distinguished diagnosis between complete and partial hydatidiform mole with coexistent fetus?

OC12.01: Can ultrasound do distinguished diagnosis between complete and partial hydatidiform mole with coexistent fetus?

Molecular cytogenetic analysis of a hydatidiform mole with coexistent fetus: a case report

BackgroundA hydatidiform mole with a coexisting fetus is a rare condition that commonly occurs as either a partial mole with fetus or a twin pregnancy comprising a complete mole and normal fetus. In the former case, the fetus is triploid, and in the latter case, the fetus is diploid with different alleles from those of the mole. Because there is a difference in the persistent trophoblastic disease incidence between the two, an accurate diagnosis is required.Case presentationWe present a case of a 34-year-old Japanese woman who was pregnant with a hydatidiform mole and two coexisting fetuses. At 17 weeks of gestation, hemorrhage-induced progressive anemia in the mother prompted the decision to terminate the pregnancy, after which no complications occurred. Molecular cytogenetic analysis revealed that one of the fetuses was a normal diploid fetus with the same allele in the fetus and placenta. The hydatidiform mole was revealed to be a mosaic of two diploids, and the other coexisting fetus was a normal diploid that shared one of the mole alleles.ConclusionsThis was presumed to be a rare case of twin pregnancy by triploid embryo formation, followed by loss of an allele due to postzygotic diploidization, development of a diploid fetus, and development of another fetus from a separate embryo. Because of the existence of cases such as this one with a diploid fetus, but without a normal pregnancy coexistent with a complete hydatidiform mole, diagnosis by genetic analysis is required for prognosis.

Molar pregnancy with normal viable fetus presenting with severe pre-eclampsia: a case report

BackgroundWhile gestational trophoblastic disease is not rare, hydatidiform mole with a coexistent live fetus is a very rare condition occurring in 0.005 to 0.01% of all pregnancies. As a result of the rarity of this condition, diagnosis, management, and monitoring will remain challenging especially in places with limited resources and expertise. The case we report is an interesting rare case which presented with well-described complications; only a few similar cases have been described to date.Case presentationWe report a case of a 21-year-old local Sarawakian woman with partial molar pregnancy who presented with severe pre-eclampsia in which the baby was morphologically normal, delivered prematurely, and there was a single large placenta showing molar changes.ConclusionEven though the incidence of this condition is very rare, recognizing and diagnosing it is very important for patient care and it should be considered and looked for in patients presenting with pre-eclampsia.

A case of complete hydatidiform mole with coexistent fetus developing hypertension and acute heart failure

A case of complete hydatidiform mole with coexistent fetus developing hypertension and acute heart failure

Twin Pregnancy with One Fetus and One Complete Mole - A Case Report.

Twin pregnancy consisting of one fetus and one complete mole (CMCF, complete hydatidiform mole and a coexistent fetus) is an obstetric rarity with an incidence of 1/22 000 to 1/100 000 pregnancies. Associated risks include prematurity, intrauterine death, vaginal bleeding, preeclampsia, hyperthyroidism, theca lutein cysts, uterine rupture and the development of malignant neoplasia in the form of a trophoblastic tumour (GTD, persistent gestational trophoblastic disease), which is thought to be the most common complication. We report the case of a 33-year-old patient diagnosed with CMCF in the 15th week of pregnancy. After comprehensive counselling the patient chose to proceed with her pregnancy under close observation and prophylactic fetal lung maturation. We were able to extend the pregnancy to 32 weeks gestation when heavy vaginal bleeding forced a decision to deliver by caesarean section.

Maternal Klippel–Trenaunay Syndrome with Complete Hydatidiform Mole and Coexistent Fetus: A Case Managed by Surgical Evacuation with Review of the Literature

Introduction Klippel–Trenaunay syndrome (KTS) is a rare triad of congenital vascular malformations involving extensive port-wine stains, soft tissue or bone hypertrophy and underlying venous and/or lymphatic malformation affecting limb, pelvic or abdominal organs. Pregnancies with a hydatidiform mole and a live fetus are extremely rare, arising in about 1 in 20,000–1,00,000 pregnancies.

Twin Pregnancy with Complete Hydatidiform Mole and Co-existent Live Fetus

AbstractA 14-week pregnant woman had a mixed echogenic mass of size 4x12 cm at placenta portion and normal fetus at ultrasound. The image of the mass was very similar to a huge subchorionic hematoma (SCH). The fetal chromosomes by amniocentesis were normal. The presumed diagnoses were huge SCH or twin pregnancy with complete hydatidiform mole and co-existent fetus (CHMCF). A male fetus weighing 760 g was delivered at 25 gestational weeks. The findings on the placental biopsy showed twin pregnancy with CHCMF. With ultrasound findings of this type, the possibility of a huge SCH and twin pregnancy with CHMCF should be considered.

EARLY ONSET PERIPARTUM CARDIOMYOPATHY FOLLOWING DILATION AND EVACUATION FOR COMPLETE HYDATIDIFORM MOLE COEXISTENT WITH LIVE FETUS

Peripartum cardiomyopathy (PPCM) is a rare disorder (1 case per 1,000 to 4,000 live births). Complete hydatidiform mole and coexistent fetus (CMCF) is even less common (1 in 22,000 to 100,000 pregnancies). A 33 year old primigravida with no remarkable past medical history was admitted at 12 weeks

Grossesse gémellaire avec môle complète et fœtus sain coexistant : atteindre la viabilité fœtale est possible

Twin pregnancies combining complete hydatidiform mole and coexistent fetus are a rare situation (incidence in 1/20,000 in 1/100,000pregnancies) and a challenge for diagnosis. Their complications can be important-bleeding, preeclampsia, miscarriage-and their management remains complex and controversial. In case of continuing the pregnancy, nearly 40% of women have lives babies. Three quarters of fetal loss occur before 24weeks gestation. We report here three new cases; only one of these cases had a favorable outcome.

Les grossesses gémellaires molaires associant une môle complète à un fœtus sain à partir de 4 cas et d’une revue de la littérature

Twin pregnancy with complete hydatiform mole and coexistent fetus is a rare clinical condition, occurring in 1in 22,000to one in 100,000pregnancies. Continuation of pregnancy in these cases is controversial because of a high risk of immediate and long-term maternal morbidity. It allows, however, in 33% of the case the delivery of a healthy child. This retrospective study included all patients presenting a complete hydatiform mole coexisting with a live twin fetus antenatally diagnosed between 2007and 2012in the level III maternity of the Strasbourg University Hospital. Informations concerning diagnostic circumstances, pregnancy follow-up and outcome were studied. Four pregnancies were included in the study, all of them were spontaneous. Medical termination of pregnancies was related to maternal reasons in the four cases. One before 17weeks of gestation, the three other after 2weeks of gestation, leading to delivery of a healthy child. All patients developed a mild to severe preeclampsia. One patient developed a gestational trophoblastic disease, requiring chemotherapy by methotrexate. There was no fatal evolution. Twin pregnancy with complete hydatifom mole and coexistent fetus is associated with increased risk of gestational trophoblastic disease. This risk is not increased by continuation of pregnancy. In case of prenatal diagnosis of complete hydatiform mole coexisting with a live twin fetus, patients should be aware of the potential high risk of morbidity and a regular follow-up during and after the pregnancy should be intaured. In absence of maternal complications, continuation of the pregnancy is possible.

Molar Pregnancy with a Co-Existing Viable Fetus

DOI: 10.4328/JCAM.830 Received: 12.10.2011 Accepted: 13.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 88-90 Corresponding Author: Ruya Deveer, 30. Cad. 340. Sk. Mutlu Apt. 5/5, Cigdem Mah., Cankaya, Ankara, Turkey. GSM: +905063801350 E-Mail: deveer3@hotmail.com Ozet Bu calismanin amaci molar gebelikle birlikte olusmus canli fetus olgusunu literatur esliginde sunmaktir. Hiperemezis gravidarum ve hipertiroidizm bulgulari ile ortaya cikan ve yaygin plasental molar degisiklikle normal fetusun birliktelik gosterdigi gebelik olgusuna amniyosentez uygulandi. Normal karyotipli fetus saglikli bir sekilde terme ulasti. Sezaryen ile dogurtuldu. Molar gebelikle birlikte normal karyotipli fetus varliginda annenin yakin takibiyle gebeligin devami onerilebilir.

A case of complete hydatidiform mole with coexistent fetus leading to peripartum cardiomyopathy

The cell-associated glucansucrase from Leuconostoc citreum SK24.002 was isolated, purified, characterized and used for de novo synthesis of α-glucan and acceptor-products. The final specific glucansucrase activity was 1.4 U/mg protein with 13.2-fold purification. The obtained glucansucrase had a molecular weight of 186 kDa, Tm of 61.7 °C and ⿳H of 176.7 kJ/mol. The enzyme showed maximum activity at pH 5.0-6.0 and 45 °C. The enzyme activity was enhanced by Ca2+, Mn2+ or Co2+ ions, whereas the activity decreased as the methanol, ethanol, n-butanol, DMSO or isopropanol concentration increased. The chemical inhibitors including BD, DTNB, EDC or NBS also significantly inhibited enzyme activity. Km, Vmax and kcat of glucansucrase were 10.9 mM, 3.6 U/mg and 306.6 1/s, respectively. For de novo synthesis from sucrose, α-glucan polymer with molecular weight of 1.5 ÿ 107 g/mol and maltose acceptor products (trisaccharide, tetrasaccharide and pentasaccharide) were obtained by glucansucrase via glucosyltransfer reactions, respectively.