Complete Molar Cervical Previal Pregnancy with Second Healthy Twin and Placental Percretism after Corporeal Hysterotomy One Year Ago
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Abstract
Background: Coexisting monozygotic twin molar pregnancies with a living second fetus are known in the literature, with various outcomes and treatment options. Methods: Clinical praesentation of two separate throphoblastic diseases that became directly conditioned. Results: A 33-year-old nuliparous woman, after autolog insemination one blastocysts with extremely high MoM free BHCG, and in the 17th week of pregnancy, bled profusely where ultrasound found a dilated cervix filled with a mass similar to molar tissue with intact second gestational sac. The gynecologists decided on a laparotomy, so they performed a corporeal hysterotomy at the 19th week of pregnancy. A year later, the patient became pregnant spontaneously with an orderly course of pregnancy until the 30th week. Due to the acute abdomen, an emergency caesarean section is indicated, and after the laparotomy, 1000 mL of fresh blood and clots are found with a 5 cm zone of cicatricial percretism. A freshly dead male newborn 1530 g/ 44 cm, without the effect of the resuscitation procedure. With regard to cicatricial percretism, the gynecologist on duty decides on a supracervical hysterectomy.; Conclusions: The treatment approach to molar pregnancy that influenced the outcome of the second pregnancy and the overall poor reproductive outcome is discussed.
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