Case report: Uneventful at term twin pregnancy starting three months after complete hydatidiform mole diagnosis

OBJECTIVE: To report an uneventful twin pregnancy begun
only three months after evacuation of complete hydatidiform
mole.
DESIGN: Case report.
SETTING: Department of obstetrics and gynecology of P.O. M.
Melloni, Milan.
PATIENT: A 38 year-old woman, gravida, treated for complete
hydatidiform mole with successive uterine cavity evacuation
85 days before her last menstrual period.
INTERVENTIONS: After being diagnosed with hydatidiform
mole the patient was treated with uterine cavity evacuation.
One undetectable hCG level was then obtained. With the
occurrence of a new pregnancy, the patient underwent
transvaginal ultrasound (US) that revealed a twin dichorial
diamniotic pregnancy; she then underwent normal antenatal
tests and care. Histological examination of the placentas was
performed after delivery.
MAIN OUTCOME MEASURES AND RESULTS: The pregnancy
progressed normally until the 38th week of gestation, when
spontaneous rupture of membranes and uterine contractions
occurred. Two healthy foeti were delivered vaginally.
CONCLUSIONS: Patients who conceive before the completion
of the full 6-12 months hCG follow-up, albeit having one
undetectable hCG value, should be encouraged to continue
their pregnancy.