A case of complete hydatidiform mole with coexistent fetus developing hypertension and acute heart failure

Abstract

Twin gestation consisting of complete hydatidiform mole with coexistent fetus (CHMCF) is a very rare entity. CHMCF is associated with serious complications, such as vaginal bleeding, intrauterine death, preterm birth, preeclampsia, and persistent gestational trophoblast disease (pGTD). Thus, management of this type of pregnancy is challenging. Here we report a case of CHMCF complicated with hypertension and acute heart failure. A 33-year-old primigravida female was clinically diagnosed with CHMCF at 12 weeks of gestation and then developed hypertension and proteinuria at 14 weeks of gestation. Elective termination of pregnancy was performed at 15 weeks of gestation and, following the procedure, she suffered from acute heart failure, suggesting peripartum cardiomyopathy. She subsequently developed pGTD, and methotrexate treatment was initiated. Since CHMCF can cause a variety of complications, its clinical management should be performed with discretion after obtaining informed consent.