Complete hydatidiform mole and a coexistent viable fetus: report of two cases and review of the literature.
OBJECTIVE
The aim of this study was to report the clinical features, management, and outcome of two cases of complete hydatidiform mole with a coexisting viable fetus and to review the literature.


METHODS
In this article, we report on the well-documented follow-up of 2 cases of twin pregnancies with complete hydatidiform mole and a viable fetus, both of which ended with the delivery of a normal infant at 41 and 26 weeks of gestation. It is of interest that both pregnancies were achieved following induction of ovulation with hMG/hCG. Since 1977, the year in which complete and partial moles were characterized as distinct pathologic entities, 15 cases (including our 2) have been reported.


RESULTS
Persistent GTT developed in eight patients (53.3%) and four patients (27.7%) developed metastatic disease. Seventy-five percent patients with persistent GTT were treated with single-agent chemotherapy. The median gestational age of the patients with subsequent persistent GTT was 34.5 weeks compared to 38 weeks in the patients without persistent GTT.


CONCLUSIONS
Complete hydatidiform mole and coexistent fetus is a rare occurrence and is associated with an increased risk of persistent gestational trophoblastic tumor. Based on currently available information, it seems that in the presence of a stable pregnancy, normal karyotype, and a normal sonogram it is reasonable to allow the pregnancy to continue.
Bruchim
I
I
Department of Obstetrics and Gynecology, Meir Hospital, Kfar Saba, Israel.
Kidron
D
D
Amiel
A
A
Altaras
M
M
Fejgin
M D
MD
D000328:Adult; D005260:Female; D005328:Fetal Viability; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D010062:Ovulation Induction; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy / Q000473:pathology*; D011256:Pregnancy Outcome; D012307:Risk Factors; D014328:Trophoblastic Neoplasms / Q000209:etiology*; D014427:Twins; D014594:Uterine Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology*