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Coexisting complete hydatidiform mole & live pregnancy
*For correspondence: sunithapradeepnair19@gmail.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 27 yr old pregnant woman† presented to the department of Radiodiagnosis of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, in May 2018 for routine second trimester antenatal ultrasound scan. She was asymptomatic and gestational age according to her last menstrual period was 19 wk two days at presentation.
B-mode ultrasonography revealed a live intrauterine foetus of gestational age 16 wk zero day with no gross anomalies with placenta located anteriorly (Fig. 1A). There was another intrauterine amniotic sac which contained a heterogeneous isoechoic mass with multiple cystic areas along the posterior aspect of the uterine cavity (Figs. 1 and 2). Colour Doppler imaging showed mild internal vascularity. The possibility of dichorionic diamniotic twin pregnancy with complete hydatidiform mole of one sac and live foetus in the other sac was suggested. Due to high morbidity associated with continuation of pregnancy, treatment strategy is challenging. In view of high beta-human chorionic gonadotropin (2×105 mIU/ml) and gestational age being 20 wk, pregnancy was terminated. Histopathology confirmed complete hydatidiform mole. There was no post-procedural complication and the patient recovered completely on follow up after six weeks.
- B-mode ultrasonography of uterus showing (A) normal placenta (P) (B) of live foetus (arrow) corresponding to 16 wk zero day anteriorly and posteriorly heterogeneous isoechoic mass with cystic spaces (star) suggesting molar pregnancy. HC, head circumference; BPD, biparietal diameter.
- B-mode ultrasonography of uterus showing dichorionic diamniotic twin gestation. Arrow head pointing to the thin intertwin membrane. (A) One sac containing live foetus (arrow) and (B) another sac showing heterogeneous isoechoic mass with cystic spaces (star) suggesting molar pregnancy.
Acknowledgment
Authors thank Dr D. Jayalakshmy, department of Obstetrics and Gynaecology, JIPMER, Puducherry, for substantial contribution.
Conflicts of Interest: None.
