A 28-year-old woman at 14 weeks has a uterus large for dates and beta-hCG of 900,000 mIU/mL. Ultrasound shows a normal-appearing singleton fetus with its own placenta, plus a separate multicystic vesicular placental mass. Amniocentesis shows a normal diploid male karyotype. What is the correct interpretation and implication?
- A Twin pregnancy with complete mole and coexisting normal fetus; continuation is possible but risk of persistent gestational trophoblastic neoplasia is substantially increased ✓
- B Partial mole; pregnancy must be terminated immediately
- C Placental mesenchymal dysplasia; benign, requires no oncological follow-up
- D Complete mole with pseudo-fetus; karyotype result indicates lab error
Correct answer: A. Twin pregnancy with complete mole and coexisting normal fetus; continuation is possible but risk of persistent gestational trophoblastic neoplasia is substantially increased
Explanation
B normal diploid fetus separate from a vesicular mass represents a dizygotic twin gestation comprising one normal conceptus and one complete mole, unlike a partial mole where the triploid fetus is part of the same abnormal conception. Continuation may be offered if the karyotype is normal and complications such as early preeclampsia or haemorrhage do not force delivery, but reported risk of persistent gestational trophoblastic neoplasia is around 20 percent, higher than for a complete mole alone, mandating postpartum hCG surveillance.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.