Twin gestation with complete molar pregnancy and coexisting normal fetus: Case report

Twin pregnancy consisting of a complete hydatidiform mole with a coexisting normal fetus is an extremely rare obstetric condition and presents significant diagnostic and management challenges. These pregnancies are associated with markedly elevated β-human chorionic gonadotropin (β-hCG) levels and increased maternal risks including hemorrhage, preeclampsia, thyrotoxicosis, and development of gestational trophoblastic neoplasia. Early identification through ultrasound and biochemical markers is essential for appropriate counselling and management. A case of complete molar pregnancy with a coexisting fetus was diagnosed at 21 weeks during a routine anomaly scan. Termination of pregnancy was considered after detailed counseling due to maternal and fetal risk. Histopathological examination confirmed the diagnosis of a complete hydatidiform mole with a separate normal placenta. This case highlights the importance of antenatal imaging, multidisciplinary counseling, and close follow-up with serial β-hCG monitoring.