Persistent complete hydatidiform molar pregnancy following assisted reproductive technology in a gestational carrier: Case report

A hydatidiform mole is a rare pathology associated with pregnancy, attributed to abnormal gametogenesis and fertilization. When assisted reproduction techniques (ART) are used, the incidence of molar pregnancy is significantly lower however not eliminated. We report a case of a patient serving as a...

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Bibliographic Details
Main Authors: Oleksandra Dzyubak, Jamie Lee Fritz, Taryn Taylor, Jacob McGee
Format: Article
Language:English
Published: Elsevier 2020-11-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578920301120
Description
Summary:A hydatidiform mole is a rare pathology associated with pregnancy, attributed to abnormal gametogenesis and fertilization. When assisted reproduction techniques (ART) are used, the incidence of molar pregnancy is significantly lower however not eliminated. We report a case of a patient serving as a gestational carrier who developed a complete molar pregnancy, with features indicating persistent trophoblastic disease. This 33-year-old G4T3P0A1L3 woman presented with bleeding at 8 weeks gestational age, after in vitro fertilization and frozen embryo transfer. Ultrasound findings and beta-HCG levels were consistent with molar pregnancy. Pathology specimen from D&C confirmed a complete hydatidiform mole. Despite surgical treatment, beta-HCG remained elevated and multiple pulmonary nodules and enlarged lymph nodes were noted on imaging. Methotrexate was considered but was deemed unnecessary because beta-HCG levels returned to normal over time and nodules resolved. Because molar pregnancy carries a risk of malignant transformation, albeit low, individuals undergoing ART should be counselled.
ISSN:2352-5789