Korean J Obstet Gynecol.  2010 May;53(5):443-448. 10.5468/kjog.2010.53.5.443.

Twin pregnancy with diploid partial hydatidiform mole and coexisting fetuses following in vitro fertilization and embryo transfer: A case report

• Kim EK
• Jeong YJ

• KMID: 2273877
• DOI: http://doi.org/10.5468/kjog.2010.53.5.443

Abstract

A 24-year-old woman, gravida 1, para 0, was referred to our hospital at 14 weeks of gestation due to suspected twin pregnancy with hydatidiform mole and coexisting fetuses. The present pregnancy was achieved following in vitro fertilization and embryo transfer (IVF-ET). Ultrasound examinations at 14 weeks 3 days of gestation revealed a live fetus appropriate for assigned gestational age with a normal-looking placenta and a dead fetus with an additional echogenic mass resembling molar placenta. The patient was planned to take amniocentesis for chromosomal analysis. However, regular uterine contraction was developed and spontaneous expulsion was occurred at 14 weeks 4 days of gestation. Chromosomal analysis of twin pregnancy using normal and molar placental tissues revealed normal karyotype with 46,XY, 46,XX, respectively. Follow-up showed no progression to persistent gestational trophoblastic disease. We present a twin pregnancy with diploid partial hydatidiform mole and coexisting fetuses that occurred following IVF-ET, which was aborted spontaneously.

Keyword

Diploid; In vitro fertilization and embryo transfer; Partial hydatidiform mole; Twin pregnancy; Ultrasonography

MeSH Terms

Amniocentesis
Diploidy
Embryo Transfer
Embryonic Structures
Female
Fertilization in Vitro
Fetus
Follow-Up Studies
Gestational Age
Gestational Trophoblastic Disease
Humans
Hydatidiform Mole
Karyotype
Molar
Placenta
Pregnancy
Pregnancy, Twin
Uterine Contraction
Young Adult

Figure

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  Fig. 1 Transabdominal ultrasonographic findings at 14 weeks 3 days of gestation. (A) A uterus contains diffuse multiple hypoechoic cysts. An omphalocele (arrow) is seen. (B) A coexisted live fetus with normal placenta is seen in the uterus. t1:twin 1, t2: twin 2.

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  Fig. 2 Postmortem photograph. Ruptured omphalocele (arrow) is seen. t1:twin 1, t2: twin 2.

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  Fig. 3 Pathologic findings. (A) Gross picture of the molar placenta (arrow) showing a diffuse cluster of molar vesicles. (B) Microscopic picture of the molar placenta showing an admixture of normal villi (arrow head) and molar villi displaying scalloped outlines (H&E stain, ×100).

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  Fig. 4 The course of β-hCG levels after spontaneous abortion.

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