title: Uterine rupture in twin pregnancy with normal fetus and complete hydatidiform mole.
abstract: We describe a rare case of complete hydatidiform mole with twin live fetus (CHMTF) confirmed by histopathology, flow cytometry and polymerase chain reaction techniques. No malformations were observed, fetal karyotype was normal and β-human chorionic gonadotropin levels were high (>100,000 IU/ml). The patient was informed of the risks and decided to continue with the pregnancy, but at week 15, she had to undergo hysterectomy due to uterine rupture. She subsequently developed persistent trophoblastic disease (PTD) with pulmonary metastases that required treatment with polychemotherapy. Patients with CHMTF should be informed of all known risks, including the considerable risk of PTD, which is similar to or, even higher than that associated with a singleton complete mole. The risk does not appear to be increased by continuing the pregnancy. Because so few series have been published, there is a lack of evidence-based clinical management guidelines. To our knowledge, this is the first report of uterine rupture in CHMTF.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Sánchez-Ferrer
authors.forename: Florentina
authors.initials: F
authors.lastname: Hernández-Martínez
authors.forename: Francisco
authors.initials: F
authors.lastname: Machado-Linde
authors.forename: Belén
authors.initials: B
authors.lastname: Ferri
authors.forename: Pablo
authors.initials: P
authors.lastname: Carbonel
authors.forename: Anibal
authors.initials: A
authors.lastname: Nieto-Diaz
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000473:pathology*; D006801:Humans; D006828:Hydatidiform Mole / Q000473:pathology*; D007044:Hysterectomy / Q000379:methods; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy; D018895:Microsatellite Repeats / Q000235:genetics; D011247:Pregnancy; D059285:Pregnancy, Twin; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology*; D014597:Uterine Rupture / Q000601:surgery*
chemical_list: D006063:Chorionic Gonadotropin