Case Report
 
A molar pregnancy accompanying a living fetus in a twin pregnancy with persistence of the molar pregnancy after uterine evacuation a clinical dilemma with a good outcome: A Case Report
Souzan M. Al Kafy1, Abdullah K. Agabawi2
1Assistant Professor and Consultant of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Medical College, King Abdulaziz University, P.O Box 80215, Jeddah, Saudi Arabia
2Demonstrator of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Medical College, King Abdulaziz University, P.O Box 80215, Jeddah, Saudi Arabia

Article ID: 100037Z08SK2018
doi: 10.5348/100037Z08SK2018CR

Corresponding Author:
Souzan M. Al Kafy
Assistant Professor and Consultant of Reproductive Endocrinology and Infertility
Department of Obstetrics and Gynecology, Medical College
King Abdulaziz University, P.O Box 80215, Jeddah, Saudi Arabia

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How to cite this article
Al Kafy SM, Agabawi AK. A molar pregnancy accompanying a living fetus in a twin pregnancy with persistence of the molar pregnancy after uterine evacuation a clinical dilemma with a good outcome: A Case Report. J Case Rep Images Obstet Gynecol 2018;4:100037Z08SK2018.


ABSTRACT

Introduction: Molar pregnancy as an abnormal gynecological condition and a devastating event to the physician and the mother. Some races have been shown to have a higher incidence of that. Moreover, Incidence have varied between nations. The presence of a molar pregnancy accompanying a normal living fetus is a very rare presentation that is way more devastating to the mother and her physician as it has been associated with many medical problems plus an increased risk of persistence and the development of metastatic disease.

Case Report: A 38-year-old female G5P3+1 who had a previous single cesarean section came from another facility on her 10th week of gestation as a case of vaginal bleeding which was discovered to be a twin pregnancy containing a normal fetus and an accompanying molar pregnancy. What made it worse is that she developed hyperthyroidism which was very hard to be treated by medications. Her thyroid status went back to normal after the final treatment. Unfortunately, she went back with persistent disease that was treated with chemotherapy until full recovery.

Conclusion: Females who present with such cases are at an extremely high risk of many medical problems that need to be solved in order they get the best management. Treating expectantly may be considered in option in case the mother’s life is not at risk and the fetus is well developed. If any risk is present evacuation is the best option. Moreover, persistent disease is another catastrophe that needs to be treated wisely in order to achieve full recovery.

Keywords: Hyperthyroidism, Molar pregnancy, Persistent molar pregnancy, Twin pregnancy


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Author Contributions
Souzan M. Al Kafy – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Abdullah K. Agabawi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Consent Statement
Written informed consent was obtained from the patient for publication of this case report.
Conflict of Interest
Author declares no conflict of interest.
Copyright
© 2018 Souzan M. Al Kafy et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.