Spontaneous Resolution of Molar Tissue in Complete Hydatidiform Mole With a Coexisting Fetus

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2025-09-04 DOI:10.1002/bdr2.2525

Paz Ahumada-Droguett, Trinidad Arancibia, Helga Vera, Daniel Martin, Francisco Sánchez, Juan Carlos Bustos

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Abstract

Background

Complete hydatidiform mole with a coexisting fetus (CMCF) is a rare form of twin pregnancy associated with high maternal and perinatal risks, posing complex diagnostic and therapeutic challenges. The standard approach ranges from termination of pregnancy to conservative management to fetal viability. Recent evidence suggests that spontaneous regression of molar tissue may occur, supporting conservative treatment in selected cases. We present a new case and discuss the clinical consequences of this phenomenon.

Case

We report a 29-year-old woman with a history of a previous molar pregnancy who presented with CMCF during her second gestation. The diagnosis was established at 21 weeks' gestation based on ultrasound findings and an elevated beta-hCG level of 454,000 mIU/mL. After multidisciplinary counseling, expectant management was indicated with close clinical, sonographic, and biochemical surveillance. By 30 weeks, significant regression in molar tissue was observed, and by 36 weeks, the appearance on ultrasound was like a normal placenta with decreased beta-hCG levels. At 37 weeks, a cesarean section was performed, resulting in the delivery of a healthy female infant weighing 2585 g. The placenta was normal and small, necrotic-appearing placental tissue. Histopathological analysis confirmed the presence of gestational trophoblastic disease with extensive necrosis.

Conclusions

This is the third reported case of spontaneous regression of molar tissue in CMCF, with resolution occurring in the third trimester. This finding opens a new perspective for the management of these complex pregnancies, suggesting that conservative strategies may be justified in selected patients under close surveillance.

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与胎儿共存的完整葡萄胎中磨牙组织的自发溶解

背景完全葡萄胎合并胎儿（CMCF）是一种罕见的双胎妊娠，具有较高的母体和围产期风险，具有复杂的诊断和治疗挑战。标准的方法包括从终止妊娠到保守管理到胎儿生存能力。最近的证据表明，磨牙组织可能发生自发退化，支持保守治疗。我们提出一个新的病例，并讨论这种现象的临床后果。病例我们报告了一位29岁的女性，她有过磨牙妊娠史，在她的第二次妊娠期间出现了CMCF。根据超声检查结果和45.4万mIU/mL的β - hcg水平升高，在妊娠21周时确诊。多学科咨询后，准管理指示密切的临床，超声和生化监测。到30周时，观察到磨牙组织明显退化，到36周时，超声外观与正常胎盘相似，β - hcg水平降低。37周时，进行了剖宫产手术，生下了一名体重2585克的健康女婴。胎盘正常，胎盘组织小，呈坏死状。组织病理学分析证实存在妊娠滋养细胞疾病伴广泛坏死。结论：这是第三例报道的CMCF磨牙组织自发消退的病例，在妊娠晚期出现消退。这一发现为这些复杂妊娠的管理开辟了一个新的视角，表明在密切监测下，保守策略可能是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.