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.