A dilemma in the management of CHCF is whether to follow them expectantly or to terminate the pregnancy. With a partial mole and coexisting live fetus, there is a high chance of fetal malformation and growth restriction because of associated triploidy [5]. Also, patients need to be counseled about all possible risks associated with CHCF, including the potential evolution to a gestational trophoblastic neoplasia [6]. The incidence of CHCF is increasing with in vitro fertilization, ovulation stimulation, and other fertility procedures [7]. In this unique case, the diagnosis of CHCF was made following delivery. Although cytogenetic studied were not performed, the karyotype was 46XX with a histology report supporting CHCF. However, in most situations, CHCF will be diagnosed after delivery as diagnosis can be reached only by invasive methods [8]. We should consider the possibility of CHCF in patients with vaginal bleeding and an ultrasound abnormality suggestive of a placental mass. If there is a strong suspicion of CHCF, an amniocentesis should be performed to rule out triploidy associated with a partial hydatidiform mole.
In conclusion, a detailed explanation and discussion about the risks and poor outcomes should be provided to the patient. Informed consent for interventions that may prolong the pregnancy should be obtained. A patient who desires to continue with the pregnancy needs close surveillance for early detection of maternal complications. The patient should be followed with ultrasonography and beta-hCG level measurements [7]. Pertinent tests to rule out hyperthyroidism, pre-eclampsia, thrombolytic disease, as well as cervical length should be considered. Furthermore, regardless of the obstetrical risk associated with CHCF, our recommendation is to be prepared for possible procedures, such as a rescue cerclage for cervical indications. Our patient had a questionable history of cervical insufficiency, and advanced cervical dilation. Rescue cerclage was performed and the pregnancy continued until viability was reached. This unique pregnancy resulted in a healthy mother and child.