A Case of a Complete Hydatidiform Molar Pregnancy with a Co-existent Live Fetus

Abstract

Complete hydatidiform mole with a co-existent healthy fetus (CHMCF) is a rare occurrence. The estimated incidence is about 1/22,000 to 1/100,000 pregnancies. As CHMCF is often associated with a high risk of pre-eclampsia, hyperthyroidism, bilateral ovarian cysts, intrauterine fetal demise and malignant neoplasia, fetal survival should always be weighed against the risk of complications of molar pregnancy. We report a case of a 35 years-old patient with raised β-hCG levels of 10.2 MoM and sonographic findings suggestive of a molar pregnancy at 15 weeks, who chose to continue the pregnancy after extensive counselling. With close surveillance, we managed to continue the pregnancy till 36 weeks, when the pregnancy was terminated via an elective Caesarean in view of fetal growth restriction with oligohydramnios, cerebral redistribution and previous 2 LSCS. A baby boy weighing 1600 grams was born with an Apgar score of 8, 9. Placental histopathology and microscopy showing large distended and cystic dilated villi with odematous cores was suggestive of a hydatidiform mole confirming our diagnosis of CHMCF.