Prenatal diagnosis of molar pathologies coexisting with a fetus. Review of the recent literature and a case report

A case of twin pregnancy combining a complete mole and a normal pregnancy is reported. A spontaneously aborted partial triploid mole was found in the past medical history of the patient. Prenatal investigations showed an heterogenous mass suggestive of a trophoblastic disorder coexisting with a normal placenta and a morphologically normal fetus on sonography associated with increased levels of hCG and normal levels of AFP in the maternal serum. High-resolution color Doppler imaging showed no blood flow within the suspect mass, excluding a myoma in necrobiosis or a large placental chorioangioma. The patient did not presented the severe complications classically described in classical mole and a passive conservative attitude was adopted. The pregnancy ended prematurely and the patient delivered at 27 weeks of gestation of a phenotypically normal infant. The mother and the baby had an unremarkable post-partum course. The review of the recent literature showed that partial hydatidiform mole could be separated in four categories: triploid partial moles; twin pregnancies combining a complete mole and a normal pregnancy; diploid partial mole; and pseudo-moles. Detailed sonographic examination and evaluation of maternal serum hCG and AFP should allow prenatal differential diagnosis of these pathological entities.