Molar pregnancy with a co-exist normal viable fetus and successful pregnancy outcome: a case report

Abstract

Background: Co-existence of a hydatidiform mole with a normal fetus is extremely rare and is considered as a high risk pregnancy. Methods: It was an observational study conducted during July 2020 to march 2021 Case report: A 23 year old primigravida, referred with a diagnosis of 27 weeks pregnancy with gestational choriocarcinoma. She was booked patient. USG report at 9 weeks with a single gestational sac and single fetal pole. Her complains were lower abdominal pain and brownish vaginal discharge. Thoroughly evaluated the patient to exclude distal metastasis. Serum Beta HCG was 3,23,280 IU/L. USG and fetal MRI report were single graved fetus, no anomaly detected and a large hyper echogenic soft tissue mass (10*7cm) interposed with multiple tiny cystic spaces near to placenta. Diagnosis was 28 weeks pregnancy with partial mole and high rising β HCG level. Proper counseling, the pregnancy was continued as per the patient’s desire. The pregnancy was closely monitored with serial serum β HCG, and USG. Spontaneously labour pain start at 36 weeks pregnancy and delivered a live baby per vaginally at 36 weeks with near normal Apgar score. The placenta with molar tissue was sent for histopathological examination. The histopathologically confirmed partial mole with normal placenta. Beta HCG was 20,000 ml/L at 7 days and normal at 8 weeks after delivery. Close surveillance for 6 months. After 6 month follow-up, both mother and development of her baby are alright. Conclusion: The diagnosis, management and monitoring of this condition will remain challenging because of its rarity. Though the general trend is to terminate pregnancy with coexistent mole in anticipation of complications, under close surveillance, optimal outcomes can be achieved. Bangladesh Medical Res Counc Bull 2022; 48(3): 249-253