A complete hydatidiform mole genetically identified next to a normal fetus after IVF-ET (2023)

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PLA journal of medical schools

Part 24, Number 6,

December 2009

, pages 360-365

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https://doi.org/10.1016/S1000-1948(10)60007-XGet rights and content


A complete hydatidiform mole with the fetus after in vitro fertilization and embryo transfer (IVF-ET) is a rare phenomenon. The diagnosis is often not easy due to the morphological similarity to a partial mole, but it is important for treatment. We present a recent case in which STR polymorphism analysis clearly revealed a different genetic origin of the fetal and molar parts. STR polymorphisms at 15 variable-number tandem repeat loci and one sex-determining locus detected by polymerase chain reaction, indicating that umbilical cord/placenta and molar tissue are parental and androgenic, respectively. During follow-up, the patient developed persistent gestational trophoblastic tumor (GTT), which was successfully treated with chemotherapy. In this case, STR polymorphism analysis accurately diagnosed a twin pregnancy consisting of a complete hydatidiform mole and fetus.

(Video) Hydatidiform Mole
  • WBJoneset al.

    Hydatidiform mole with coexisting fetus

    Ben J Obstet Gynecol


  • PAGVasilakoset al.

    Hydatidiform mole: two units. A morphological and cytogenetic study with some clinical considerations

    Ben J Obstet Gynecol


  • PAGMarcoreliet al.

    Diagnosis and development of a complete hydatidiform mole with a live twin fetus

    Eur J Obstet Gynecol Reprod Biol


  • jIshiiet al.

    Genetic differentiation of complete hydatidiform moles coexisting with normal fetuses by tandem deoxyribonucleic acid polymorphism analysis

    Ben J Obstet Gynecol


  • NPReyet al.

    Pathology of gestational trophoblastic tumors

    Gynecol Obstet Fertil


  • SI willet al.

    Development of postmolar trophoblastic disease after partial molar pregnancy

    Gynecologist Oncol


  • mlAgeet al.

    Prenatal diagnosis by DNA polymorphism analysis of the entire mole with co-existing twins

    Ben J Obstet Gynecol


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(Video) Complete Hydatidiform Mole - Histopathology

Supported byProduction and Research Projects of Guangdong Province(2007B090400140).

(Video) Uterus Hydatidiform mole
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Copyright © 2009. PLA Medical Faculty Journal Editorial Board. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.


What is a complete complete hydatidiform mole? ›

Complete hydatidiform moles (CHM) are abnormal pregnancies with no fetal development resulting from having two paternal genomes with no maternal contribution. It is important to distinguish CHM from partial hydatidiform moles, and non-molar abortuses, due to the increased risk of gestational trophoblastic neoplasia.

How common are molar pregnancies after IVF? ›

Around 1 in 1,000 pregnancies result in a molar pregnancy.

Can you have a molar pregnancy after IVF? ›

Likewise, the risk of recurrence of molar pregnancy with IVF ranges from 1/7 at its highest to 1/27 at its lowest. We have no data for patients who suffered 2 molar pregnancies with ART. This may be as the numbers are low, as no patients suffered 2 repeat molar pregnancies.

What is a complete hydatidiform mole with a coexisting live fetus? ›

Twin molar pregnancy with a hydatidiform mole and a coexisting live fetus is a rare form of gestational trophoblastic disease associated with an increased risk of obstetric complications and poor perinatal outcome. Prenatal diagnosis is essential for couple counseling and follow-up in Tertiary Reference Centers.

How do you treat a complete hydatidiform mole? ›

Treatment involves surgical removal of the molar pregnancy followed by surveillance of serial human chorionic gonadotropin (hCG) levels to confirm resolution of disease or to identify development of gestational trophoblastic neoplasia (GTN), which includes invasive mole, choriocarcinoma, placental site trophoblastic ...

Is a hydatidiform mole a baby? ›

As described previously, hydatiform moles arise from gestational tissue. In complete hydatidiform mole, there is no fetal tissue present; in partial hydatiform moles, there is some residual fetal tissue.

How rare is a complete molar pregnancy? ›

A molar pregnancy is an abnormality of the placenta, caused by a problem when the egg and sperm join together at fertilization. Also called gestational trophoblastic disease (GTD), hydatidiform mole or simply referred to as a “mole”, this is a rare condition occurring in 1 out of every 1,000 pregnancies.

What causes a hydatidiform mole? ›

Mutations in multiple genes have been found to cause recurrent hydatidiform mole. About 55 percent of cases of this condition are caused by NLRP7 gene mutations and about 5 percent of cases are caused by KHDC3L gene mutations. Mutations in other genes each account for a small percentage of cases.

How many molar pregnancies are cancerous? ›

Fewer than 15% of molar pregnancies become invasive and spread outside of the uterus. Choriocarcinoma. This is a cancerous tumor formed from trophoblast cells. It can grow and spread more quickly than other GTNs.

What happens if you don't remove a molar pregnancy? ›

There may be a fetus, but the fetus can't survive. The fetus usually is miscarried early in the pregnancy. A molar pregnancy can have serious complications, including a rare form of cancer. A molar pregnancy requires early treatment.

Is molar pregnancy high risk? ›

Age. All women who become pregnant have a risk of developing a molar pregnancy but the risk is very small. Researchers have found that some types of molar pregnancy are more common in certain age groups. Complete molar pregnancies are more common in mothers over the age of 45.

What happens if a molar pregnancy is not treated? ›

If a molar pregnancy is not treated or does not miscarry completely it can progress and cause a range of serious conditions (known as gestational trophoblastic neoplasia), including: persistent GTD – persistent growth of the abnormal placental tissue. invasive mole – the tumour spreads into the wall of the uterus.

What is the prognosis of complete hydatidiform mole? ›

Approximately 20% of women with a complete mole develop a trophoblastic malignancy. Gestational trophoblastic malignancies (ie, gestational trophoblastic neoplasia) are almost 100% curable.

Is hydatidiform mole the same as ectopic pregnancy? ›

Hydatidiform moles occurs due to a placental malformation; due to genetic aberration of the villous trophoblast. This is characterized by cystic swelling and trophoblastic proliferation. Molar gestation commonly develops within the uterus but may also occur in sites of ectopic pregnancy [3].

What symptoms occurs with a hydatidiform mole? ›

  • Abnormal growth of the uterus, either bigger or smaller than usual.
  • Severe nausea and vomiting.
  • Vaginal bleeding during the first 3 months of pregnancy.
Nov 10, 2022

What are the dangers of hydatidiform mole? ›

It may convert to more invasive forms of gestational trophoblastic neoplasia (GTN), endangering women's health by more severe complications. Most GTN cases originate from HM, which is associated with uterine bleeding, preeclampsia and thyroid problems.

Can hydatidiform mole cause miscarriage? ›

One possible cause of first trimester miscarriage is hydatidiform molar pregnancy, which is associated with a significantly increased risk of subsequent development of persistent gestational trophoblastic disease.

How is hydatidiform mole removed? ›

Treatment of Molar Pregnancy

A molar pregnancy (hydatidiform mole) or any type of gestational trophoblastic neoplasia is completely removed, usually by D and C with suction.

Is a hydatidiform mole cancerous? ›

A hydatidiform mole contains many cysts (sacs of fluid). It is usually benign (not cancer) but it may spread to nearby tissues (invasive mole). It may also become a malignant tumor called choriocarcinoma.

Can you naturally miscarry a molar pregnancy? ›

Some molar pregnancies will miscarry without intervention, but if doctors detect molar pregnancy by ultrasound, they usually recommend a D&C or medication in order to reduce the risk of further complications. Surgery can usually remove most complete and partial moles.

How long can a molar pregnancy survive? ›

In a complete molar pregnancy, the growth stops a fetus from developing. In a partial molar pregnancy, a fetus develops but it will be abnormal and cannot survive. At most, the fetus might survive for around three months.

Can you have a viable pregnancy with a molar pregnancy? ›

Molar pregnancy with a coexistent live fetus is a rare and challenging condition. Common clinical presentations that should alert the clinician to this rare condition include bleeding per vaginam, anemia, hyperemesis gravidarum, hypertension, thyrotoxicosis, and uterine size disproportionate to uterine age.

What is the most common type of hydatidiform mole? ›

The most common form of GTD is hydatidiform mole, also known as molar pregnancy. There are 2 types of hydatidiform moles: complete and partial. The complete hydatidiform mole is usually diploid and entirely androgenetic in origin. Most have 46,XX karyotype; a few have a 46,XY karyotype.

When do symptoms of molar pregnancy start? ›

Women with a molar pregnancy are more likely to pass blood clots or have a watery brown vaginal discharge. Some women pass pieces of the molar tissue, which can look a bit like small bunches of grapes. Bleeding caused by a molar pregnancy usually begins between weeks 6 and 12 of pregnancy.

What blood type is associated with molar pregnancy? ›

Some studies have linked low levels of carotene and vitamin A in a person's diet with a higher risk of molar pregnancy. Blood type. Specific blood types—A and AB—may slightly increase the risk of GTD. Family history of molar pregnancy.

Which molar pregnancy is worse? ›

There are two kinds of molar pregnancy. Both have the same result, so one isn't better or worse than the other. Both kinds are usually benign — they don't cause cancer. A complete mole happens when there's only placenta tissue growing in the womb.

Can a molar pregnancy become malignant? ›

A molar pregnancy contains many cysts (sacs of fluid). It is usually benign (not cancer) but it may spread to nearby tissues (invasive mole). It may also become a malignant tumor called choriocarcinoma. Molar pregnancy is the most common type of gestational trophoblastic tumor.

What is the mortality rate of hydatidiform mole? ›

Background: Twin pregnancy with a partial hydatidiform mole (PHM) and a coexistent live fetus is extremely rare. The fetus usually has a normal karyotype. The surviving rate of the fetus till lung maturity is only about 25-40%.

What are the two types of hydatidiform mole? ›

Two types of hydatidiform mole, complete and partial, have been described based on both morphologic and cytogenetic criteria (Table 1). Epidemiologic studies have reported wide regional variations in the incidence of molar pregnancies.

What is the difference between a molar pregnancy and a hydatidiform mole? ›

Molar pregnancies are a type of gestational trophoblastic disease. Gestational trophoblastic disease (GTD) is a group of conditions that cause tumors to grow in your uterus. Molar pregnancies are also called hydatidiform moles.

What are the characteristics of complete hydatidiform mole? ›

The complete hydatidiform mole is mainly diploid and usually has two sets of paternal chromosomes. In 80.0-90.0% of cases, it results from fertilization of an empty egg with a sperm that is then reduplicated in the homozygous diploid genome. In this case, the karyotype is always 46, XX, as 46, YY is non viable.

What is the most common cause of hydatidiform mole? ›

Mutations in multiple genes have been found to cause recurrent hydatidiform mole. About 55 percent of cases of this condition are caused by NLRP7 gene mutations and about 5 percent of cases are caused by KHDC3L gene mutations. Mutations in other genes each account for a small percentage of cases.

Is hydatidiform mole cancerous? ›

A hydatidiform mole contains many cysts (sacs of fluid). It is usually benign (not cancer) but it may spread to nearby tissues (invasive mole). It may also become a malignant tumor called choriocarcinoma.

What is the prognosis for hydatidiform moles? ›

Outlook (Prognosis)

About 15% of cases of HM can become invasive. These moles can grow deep into the uterine wall and cause bleeding or other complications. This type of mole most often responds well to medicines. In very few cases of complete HM, moles develop into a choriocarcinoma.

What would you expect from a patient just diagnosed with hydatidiform mole? ›

Symptoms of Molar Pregnancy

Women who have a molar pregnancy (hydatidiform mole) feel as if they are pregnant. But because molar pregnancies grow much faster than a fetus, the abdomen becomes larger much faster than it does in a normal pregnancy. Severe nausea and vomiting and vaginal bleeding are common.

What are the long term effects of molar pregnancy? ›

Complications of molar pregnancy

haemorrhage. ovarian cysts. breathlessness (when it spreads to the lungs) pre-eclampsia (toxaemia of pregnancy), involving high levels of certain substances in the blood that raise blood pressure and affect the kidneys and (sometimes) liver function.

What is the risk of malignancy in hydatidiform mole? ›

Molar pregnancy (hydatidiform moles).

They are usually slow growing and benign, although there is a chance a mole can become cancerous. A complete molar pregnancy is much more likely to become cancerous than a partial molar pregnancy.

Is hydatidiform mole rare? ›

A hydatidiform mole or molar pregnancy is very uncommon affecting around 1 in 1,200 pregnancies. It is usually found in early pregnancy. A hydatidiform mole is sometimes detected when you have an early pregnancy ultrasound.


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