Twin Pregnancy with One Fetus and One Complete Mole – A Case Report

Abstract

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.

Zusammenfassung

Die Situation einer Zwillingsschwangerschaft, bestehend aus einem Fetus und einer kompletten Mole (CMCF, complete hydatidiform mole and a coexistent fetus) ist ein seltenes geburtshilfliches Ereignis und kommt in 1/22 000 bis 1/100 000 Schwangerschaften vor. Die Risiken hierfür umfassen Frühgeburtlichkeit, einen intrauterinen Fruchttod, vaginale Blutungen, Präeklampsie, Hyperthyreose, Thekaluteinzysten, Uterusruptur, und, als wohl größtes Risiko, die Entwicklung eines Trophoblastentumors als maligne Neoplasie (GTD, persisting gestational trophoblast disease). Wir berichten über eine 33-jährige Patientin, bei der wir in der 15. Schwangerschaftswoche die Diagnose einer CMCF gestellt haben. Die Patientin entschied sich nach ausführlicher Beratung für ein Fortführen der Schwangerschaft unter engmaschiger Vorsorge sowie Durchführung einer prophylaktischen Lungenreifung. Unter diesen Umständen konnten wir die Schwangerschaft bis in die 32. Schwangerschaftswoche verlängern, als uns starke vaginale Blutungen zur Entbindung via Sectio caesarea zwangen.

Key words

gestational trophoblastic disease (GTD) - multiple birth - obstetrics - pregnancy

Schlüsselwörter

trophoblastäre Schwangerschaftstumoren - Mehrlingsgeburt - Geburtshilfe - Schwangerschaft

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