Twin Pregnancy with a Complete hydatidiform mole and a normal Co-Twin - Issues in diagnosis and management

Twin pregnancy with a complete hydatidiform mole and a live foetus is a very rare condition with an estimated frequency of 1 in 22,000 to 100,000 pregnancies. As the maternal and foetal complication rates are high, traditionally termination has been the preferred management. In recent times successful continuation of these pregnancies resulting in viable live births is being increasingly reported and has to be considered in elderly mothers after explaining the possible complications, provided the co-twin is of normal karyotype. In case of parous women as ours, termination still remains the first choice considering the risk of persistent trophoblastic disease and increased rate of complications resulting in poor pregnancy outcome.