BMJ Case Reports 2013; doi:10.1136/bcr-2013-008604

The interplay of Graves’ disease and twin molar pregnancy

  1. Elizabeth Paz-Pacheco1
  1. 1Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of the Philippines, Phillippine General Hospital, Manila, Philippines
  2. 2Department of Medicine, University of the Philippines, Philippine General Hospital, Manila, Philippines
  1. Correspondence to Dr Jerome Rebollos Barrera, jrom0330{at}


Twin molar pregnancy with coexistent viable fetus in a patient with Graves’ disease is a rare entity. The patient is a 37-year-old woman who was hospitalised owing to persistent vomiting and vaginal bleeding. The pregnancy test was positive and the pelvic ultrasound disclosed twin gestation of complete mole and a coexistent viable 12-week fetus. β-Human chorionic gonadotropin (β-HCG) and free thyroid hormones were both elevated. The patient was also a diagnosed case of Graves’ disease prior to this pregnancy. Given the risks for perinatal complications, the patient was offered early termination of pregnancy. She, however, decided to continue her pregnancy and control the hyperthyroidism with an antithyroid drug (ATD). A week after her discharge from the hospital, she had spontaneous abortion and the histopathology of the abortus revealed complete hydatidiform mole and a 13-week fetus.

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