The co-existence of a hydatidiform mole with a living fetus during the third trimester is extremely rare. The optimal management of such a case is controversial especially when medical and obstetric complications set in before term. The aim of management is towards avoidance of complications and planning the delivery at the most appropriate time to ensure good maternal and fetal outcome. We report the case of a 27-year-old Gravida 2 Para 1, who was diagnosed with a complete mole with co-existing live fetus at around 12 weeks age of gestation. She was referred to our institution at 31 weeks and 1 day age of gestation due to vaginal bleeding for which an emergency cesarean section was done. She delivered a live baby boy weighing 1.5 kg, with Apgar Score of 4,6,6. Chemoprophylaxis was administered and her serum beta human chorionic gonadotropin was monitored post-partum.
Pregnancy ; Female ; Hydatidiform Mole

Hydatidiform mole (H mole) is a rare complication of pregnancy, characterized by an atypical trophoblastic proliferation and swelling of the chorionic villi, with or without a live fetus. A clinical diagnosis of H mole is confirmed by significantly high serum beta-hCG levels and/or the presence of characteristic sonographic and histopathologic findings. Differentiation between the two types—complete or partial—is important, since complete moles pose a higher risk for malignancy. An H mole can be further complicated by the presence of a coexisting live fetus. Complete molar pregnancy with a coexisting live fetus has an incidence of only 1 in 22,000 to 100,000 pregnancies. Termination of pregnancy is usually considered, especially when a high risk of choriocarcinoma and maternal prenatal complications are present. We present the case of a 27-year-old female diagnosed as having a complete H mole with a coexisting live fetus. We terminated the pregnancy due to profuse vaginal bleeding that could cause maternal and fetal compromise.
Choriocarcinoma ; Placental mesenchymal dysplasia ; Methotrexate ; Gestational Trophoblastic Disease ; Hydatidiform mole