Successful live birth with co-existing Molar Pregnancy : A Rare Case Report

Dr. Hind Elyan, Dr. Mohamed Aoun Hakmi  ( Tawam hospital, UAE)

 

Background:

 

Twin pregnancy with both molar and a viable fetus is rare (~0.005–0.01% of all pregnancies). Most common: complete mole + viable fetus with separate placentas. Associated Risks: hyperemesis, spontaneous miscarriage , PET, IUGR, IUFD, GTN. Historically advised termination. Trend now toward continuation if stable.

 

Objective:   review of  a rare case of a molar pregnancy with co-existing  viable pregnancy and it’s its outcome

 

 

Case: A 44-year-old G2P1, previous vaginal delivery with IVF pregnancy with 2 embryo transfer. Scan  at 13+6 weeks: twin sacs, one with viable fetus, other with cystic molar tissue with no fetal pole . βhCG: 520,774 IU. Patient opted for continuation of pregnancy following thorough counselling  of risks. ANC visits biweekly with close monitor of blood pressure and protein in urine. At 32 weeks the patient admitted with sever PET and hence underwent emergency C-section. Delivered healthy male, Placenta confirmed complete mole.

 

During postpartum monthly follow up ,βhCG dropped to 0.2 by 4 months postpartum

 

Increased risk seen in IVF, Asian ethnicity, maternal age >35. Continuation feasible in selected cases with close monitoring. Literature shows ~21% result in live births; GTN in ~50%. Case reinforces value of individualized management.

 

Conclusion:   Though rare and high-risk, successful outcomes are possible with vigilant monitoring in tertiary care. Shared decision-making is crucial