A 27-year-old woman at 14 weeks gestation has ultrasound showing a normally formed fetus with a separately visualised echogenic vesicular placental mass. Serum beta-hCG is markedly elevated. She strongly desires to continue the pregnancy. Which statement about her condition is correct?
- A Termination is mandatory because progression to choriocarcinoma is certain
- B This is a dizygotic twin gestation with one normal conceptus and one complete mole, and continuation may be considered after counselling ✓
- C This is a partial mole in which one fetus survived, and the fetal karyotype will be triploid
- D The vesicular mass is a submucous fibroid undergoing hyaline degeneration
Correct answer: B. This is a dizygotic twin gestation with one normal conceptus and one complete mole, and continuation may be considered after counselling
Explanation
Twin pregnancy with a complete mole and coexisting normal fetus arises from two separately fertilised ova: the fetus is euploid and its own placenta is normal, while the other conceptus is a complete mole. Continuation can be offered with counselling about preterm delivery, preeclampsia, and haemorrhage. The risk of persistent gestational trophoblastic neoplasia is increased, around 15 to 20 percent, but malignancy is not inevitable, and the fetus in a partial mole would be triploid, which does not apply here.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.