title: [Twin pregnancy with a complete hydatiform mole and a viable co-twin].
abstract: A complete hydatiform mole coexisting with a live, viable twin is a rare event. The diagnosis is challenging, and is normally achieved only at second trimester. It may be associated with thyrotoxicosis, vaginal bleeding, preeclampsia, fetal death or persistent throphoblastic disease. The authors describe the case of a pregnant woman presenting with first trimester bleeding. Ultrasound revealed a twin pregnancy with a viable twin and another placenta apparently detached. At 16 gestational weeks ultrasound revealed a live fetus with a normal placenta and a separate vacuolated and vascularized mass. Facing the hypothesis of gestational trophoblastic disease, the couple chose pregnancy interruption. Given the rarity of this situation, a high index of suspicion is needed to achieve the diagnosis. Despite the existence of case reports with good fetal and maternal outcome, the decision of pregnancy continuation should be made by the informed parents.
authors.affiliation: Departamento de Obstetrícia, Ginecologia e Medicina da Reprodução. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.. godinho.ab@gmail.com.
authors.forename: Ana Beatriz
authors.initials: AB
authors.lastname: Godinho
authors.affiliation: Departamento de Obstetrícia, Ginecologia e Medicina da Reprodução. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.. godinho.ab@gmail.com.
authors.forename: Diana
authors.initials: D
authors.lastname: Martins
authors.affiliation: Departamento de Obstetrícia, Ginecologia e Medicina da Reprodução. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.. godinho.ab@gmail.com.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Araújo
authors.affiliation: Unidade de Ecografia. Departamento de Obstetrícia, Ginecologia e Medicina da Reprodução. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
authors.forename: Maria Antonieta
authors.initials: MA
authors.lastname: Melo
authors.affiliation: Departamento de Obstetrícia, Ginecologia e Medicina da Reprodução. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.. godinho.ab@gmail.com.
authors.forename: Luís
authors.initials: L
authors.lastname: Mendes Graça
mesh_terms: D000328:Adult; D004200:Diseases in Twins / Q000000981:diagnostic imaging*; D017809:Fatal Outcome; D005260:Female; D005313:Fetal Death; D006801:Humans; D006828:Hydatidiform Mole / Q000000981:diagnostic imaging*; D011247:Pregnancy; D059285:Pregnancy, Twin; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging*