Twin pregnancy combining a molar pregnancy and a normal fetus: obstetrical and oncological implications

Abstract

Twin pregnancies involving a hydatidiform mole and a healthy twin are rare. Several studies have reported obstetric and oncological complications. We report a case of twin pregnancy with a healthy embryo and a molar pregnancy complicated by arterial hypertension and partial invasive mole. The expulsion material consisted of a dead male foetus with its trophoblast associated with a vesicular mass measuring 16 cm. Pathological analysis of the mass confirmed the diagnosis of partial mole. Serum plasma BHCG levels taken 72 hours apart were 6336.94m IU/ml on admission and 76414.20m IU/ml on day 2 post-expulsion. Serum plasma BHCG monitoring and contraception were undertaken. Twin pregnancies involving a hydatidiform mole and a normal embryo are
often associated with complications requiring termination of pregnancy. The most feared complication is the development of a gestational trophoblastic tumour. Monitoring of plasma BHCG levels is recommended, as is oncological management in the event of
persistent high levels in adolescents as well as adults and are responsible for the same complications.