Complete Hydatidiform Mole with Coexisting Twin Fetus: Usefulness of MRI in Management Planning

Excerpt

Complete hydatidiform mole with coexistent twin fetus is a rare condition. Only one out of a total reported 16 cases before the 1980s was diagnosed antenatally; hence, there was really no need to take a clinical decision. The number of cases of CHMCTF has since gone up dramatically with the availability of advanced ultrasound and emerging IVF techniques including newer ovulation drugs [1]. The optimal management is a challenge that remains a clinical dilemma. The present viewpoint is tilted toward expectant management with strict surveillance to prevent/treat complications early, so as to be able to deliver a normal baby in many of these patients. No difference in the risk of developing persistent gestational trophoblastic disease (PGTD) and gestational trophoblastic neoplasia (GTN) in patients undergoing termination of pregnancy as well as patients allowed to continue pregnancy has permitted the clinician to delay intervention till after delivery, while successfully managing the complications associated with trophoblastic disease. The role of MRI in addition to ultrasound in correctly distinguishing this condition from the partial hydatidiform mole is discussed, thus assisting in the management plan. …