This video shows Twin molar pregnancy with Fetal demise.
Twin molar pregnancy is a rare obstetric event, characterized by the coexistence of a hydatidiform mole and a potentially viable fetus with a normal placenta, associated with several pregnancy complications, such as spontaneous abortions, intrauterine deaths, preeclampsia, and hyperthyroidism, potentially leading to an obstetric near miss.
In a complete mole, the ultrasound findings include a heterogeneous mass in the uterine cavity with multiple anechoic spaces, most commonly referred to as a "snowstorm" appearance. These small cystic areas are typically the hydropic villi.
Twin molar pregnancy with a hydatidiform mole and a coexisting live fetus is a rare form of gestational trophoblastic disease associated with an increased risk of obstetric complications and poor perinatal outcome. Prenatal diagnosis is essential for couple counseling and follow-up in Tertiary Reference Centers. Magnetic resonance imaging is important for the diagnostic differentiation of placental mesenchymal dysplasia and the exclusion of myometrial invasion. Here we present a case of twin molar pregnancy with a hydatidiform mole and a coexisting live fetus diagnosed at gestational week 11 using a two-dimensional (2D) ultrasound
Molar pregnancy is caused by a cytogenetic anomaly in fertilization and may lead to two clinical forms: a complete and partial hydatidiform mole. The clinical significance of this reproduction is the possibility of evolution to gestational trophoblastic neoplasia (GTN), which may cause maternal death if not properly treated.
Ultra-sonographic diagnosis of a twin pregnancy with a hydatidiform mole and a coexisting live fetus is feasible at the end of the first trimester. MRI is essential to differentiate a twin pregnancy with a hydatidiform mole and a coexisting live fetus from a placental mesenchymal dysplasia because the perinatal prognosis is favorable in the latter.
Two signs of a hydatidiform mole pregnancy
Symptoms
Abnormal growth of the uterus, either bigger or smaller than usual.
Severe nausea and vomiting.
Vaginal bleeding during the first 3 months of pregnancy.
Confirmatory test for hydatidiform mole.
The following laboratory studies may be used to evaluate patients with suspected hydatidiform mole: Quantitative beta-hCG levels: hCG levels greater than 100,000 mIU/mL indicate exuberant trophoblastic growth and raise suspicion for a molar pregnancy. However, a molar pregnancy may have a normal hCG level.
Molar pregnancy with a coexisting fetus carries a significant risk to both the mother and the fetus. Maternal hazards include abnormal bleeding, pre-eclampsia, eclampsia, hyperthyroidism, anemia, persistent gestational trophoblastic disease, preterm delivery, and abruption.
Hydatidiform mole is a common complication of pregnancy. It consists of a nonviable embryo that implants and proliferates within the uterus.
A hydatidiform mole can either be complete or partial. The presence or absence of a fetus or embryo is used to distinguish the complete from partial moles:
Complete moles are associated with the absence of a fetus
Partial moles usually occur with an abnormal fetus or may even be associated with fetal demise.
A hydatidiform mole can either be complete or partial. The absence or presence of a fetus or embryo is used to distinguish the complete from partial moles: complete moles are associated with the absence of a fetus. partial moles usually occur with an abnormal fetus or may even be associated with fetal demise.
Rarely, moles co-exist with a normal pregnancy (co-existent molar pregnancy), in which a normal fetus and placenta are seen separate from the molar gestation.
A hydatidiform mole is the growth of an abnormally fertilized egg or an overgrowth of tissue from the placenta. Women appear to be pregnant, but the uterus enlarges much more rapidly than in a normal pregnancy. Most women have severe nausea and vomiting, vaginal bleeding, and very high blood pressure.
On Ultrasound, it looks like a bunch of vesical with interspersed fluid seen in the whole of the uterine cavity
Mostly painless vaginal bleeding during the second trimester of pregnancy is seen. They are diagnosed by ultrasound imaging. Extremely high levels of human chorionic gonadotropin (HCG) are suggestive, but not diagnostic, of molar pregnancy.
A molar pregnancy is when there's a problem with a fertilized egg, which means a baby and a placenta do not develop the way they should after conception. A molar pregnancy will not be able to survive. It happens by chance and is very rare.
A hydatidiform mole is a pregnancy in which the placenta contains grapelike vesicles (tiny sacs) that are visible to the naked eye. The vesicles arise by enlargement of the chorionic villi by fluid. When examined under the microscope, hyperplasia of the trophoblastic tissue is noted.
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