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44 Hemorrhagic shock state following partial hydatidiform mole in a twin pregnancy: a case study
  1. Montacer Hafsi,
  2. Mraihi Fathi,
  3. Eya Kristou,
  4. Jihen Basly and
  5. Dalenda Chelli
  1. Tunis Maternity and Neonatology Center, Bardo, Tunisia


Introduction/Background Hydatidiform moles are rare gestational trophoblastic diseases, often characterized by abnormal embryonic development. In the context of twin pregnancies, the occurrence of a partial hydatidiform mole is even rarer. This case study explores a unique instance of a partial hydatidiform mole in a twin pregnancy leading to hemorrhagic shock, shedding light on its clinical presentation, management, and implications for maternal and fetal health.

Methodology A detailed retrospective analysis was conducted on a 34-year-old pregnant woman, gravida 4, para 1, who presented to our tertiary care center with severe vaginal bleeding at 14 weeks of gestation. Transvaginal ultrasound revealed the presence of a partial hydatidiform mole in one of the twin fetuses. Hemodynamic instability necessitated immediate intervention. The management included fluid resuscitation, blood transfusion, and emergent uterine evacuation via suction curettage.

Results Upon further investigation, the partial hydatidiform mole was confined to one twin, while the other was unaffected. The patient responded positively to the intervention and experienced a stable recovery. Histopathological examination confirmed the diagnosis, and the patient continued with regular antenatal care. The unaffected twin showed no signs of adverse outcomes during subsequent monitoring, and the patient delivered two healthy infants at term.

Conclusion This case highlights the importance of early detection and prompt management of partial hydatidiform moles in twin pregnancies to prevent life-threatening complications like hemorrhagic shock. Clinical suspicion, close monitoring, and timely intervention play crucial roles in ensuring a favorable outcome for both mother and unaffected fetus. Further research is needed to better understand the etiology and prognosis of such rare occurrences, ultimately contributing to improved maternal and fetal care in twin pregnancies complicated by partial hydatidiform moles.

Disclosures None

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