Androgenetic complete mole coexistent with a twin live fetus.
OBJECTIVE
The aim of this study was to evaluate the clinical course and the management policy of complete mole coexistent with a twin live fetus confirmed with DNA polymorphism in a single hospital.


METHODS
From 1981 to 1995, six patients with androgenetic complete hydatidiform mole coexistent with a twin live fetus were diagnosed by DNA polymorphism analysis. The clinical course of these six patients was analyzed.


RESULTS
Two patients chose to terminate pregnancies and four patients desired to continue the pregnancy. However, the pregnancy had to be interrupted in two patients because of severe preeclampsia and sudden intrauterine fetal death. In two patients, fetuses were growing unremarkably and normal babies were delivered at term. The development of persistent trophoblastic tumor (PTT) in these rare pregnancies was higher (50.0%: 3/6) than that of single complete mole. In three patients, serum hCG titers during pregnancy were monitored. Although serum hCG levels progressively decreased during pregnancy in one patient without PTT, hCG levels initially decreased, but subsequently increased or showed a plateau with advancing gestational age in two patients with PTT.


CONCLUSIONS
In patients with complete mole coexistent with a live fetus, the pregnancy may be allowed to continue when the fetal karyotype and development are normal and serum hCG titers are constantly falling with advancing gestational age.
Department of Obstetrics and Gynecology, Chiba University School of Medicine, Inohana 1-8-1, Chuoku, Chiba, 260-8670, Japan.
H
H
Matsui
Y
Y
Iitsuka
J
J
Ishii
H
H
Osada
K
K
Seki
S
S
Sekiya
D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000097:blood; D014427:Twins; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000097:blood / Q000175:diagnosis
D006063:Chorionic Gonadotropin