ESPE Abstracts

Background: A twin pregnancy with a coexisting complete hydatiform mole and a healthy fetus is rare, with an incidence of 1 in 22.000-100.000 pregnancies. Associated with this condition are potencially serious maternal and fetal complications.

Case Report: A 32 year old pregnant woman presented with clinical features of hyperthyroidism, confirmed by laboratory. An ultrasound scan revealed a complete hydatiform mole (CHM) and a single structurally normal fetus. Her human chorionic gonadotropin (hcg) was > 112.5000 mUi/ml. She started treatment with methimazole. At 26 weeks of gestation she developed preeclampsia, and delivered a healthy boy weighing 797 gr. After delivery she remained euthyroid, and methimazole was stopped. Hcg levels fell steadily after the removal of the hydatiform mole. In the neonatal unit the baby required 12 days of mechanical ventilation. He had normal feeding and growth. There was no clinical evidence of hypothyroidism or goiter. His thyroid function studies performed at 72 hs showed a thyrotropin (TSH) 2.95uUi/ml, free thyroxine 0.49 ng/dl, total thyroxine 2.06 mg /dl, confirmed at day 5. With diagnosis of central hypothyroidism he started treatment with levothyroxine.

Conclusion: There are very few cases reported in the literature of gestational trophoblastic disease complicated with hyperthyroidism in which the infant’s clinical and biochemical thyroid status is informed. These pregnancies should be monitored for hyperthyroidism and full clinical and biochemical evaluation should be performed on affected infants to further understand the mechanisms involved in thyroid dysfunction of the neonate.