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Downloaded from http://journals.lww.com/ultrasound-quarterly by BhDMf5ePHKbH4TTImqenVJ2toCr/9wZZjwPUWvYES9lBjFbu9i0DAnSw4JagSjiU on 10/28/2020 SRU CASE OF THE DAY Twin Pregnancy With Complete Hydatidiform Mole and Normal Coexisting Fetus Peter S. Wang, MD,*Þ and Mindy M. Horrow, MD*þ CLINICAL HISTORY A 25-year-old gravida 3, para 2 woman presented to the emergency department with vaginal bleeding. Her quantita- tive serum human chorionic gonadotropin is greater than 1,000,000 mIU/mL. What is your diagnosis? IMAGING FINDINGS The grayscale ultrasound images of the uterus demon- strate a multicystic echogenic mass in the fundus (Fig. 1) and a normal-appearing active fetus at a gestational age of approx- imately 16 weeks and 3 days with a heart rate of 157 beats per minute (Figs. 2 and 3). Associated with the fetal gestational sac is a normal-appearing anteriorly located placenta that is separate from the fundal multicystic echogenic mass (Fig. 4). FIGURE 1. A transverse ultrasound image of the PATHOLOGY uterine fundus. The patient electively terminated the pregnancy with dilatation and evacuation, yielding an immature fetus of 13 to 1,2 spermatozoa. Complete moles are characterized by diploid 14 weeks’ gestation, immature placental tissue with a 3-vessel karyotype (46, XX or 46, XY) and lack fetal or embryonic umbilical cord, and a separate edematous
Ultrasound quarterly – Wolters Kluwer Health
Published: Sep 1, 2013
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