Clinical findings of multiple pregnancy with a complete hydatidiform mole and coexisting fetus.
OBJECTIVE
The aim of this series was to evaluate the clinical features, management, and outcomes of multiple pregnancy with a complete hydatidiform mole and coexisting fetus (CHMCF).


METHODS
Between 1998 and 2008, we investigated 6 women with a diagnosis of a CHMCF. The gestational age at diagnosis, symptoms, serum b-human chorionic gonadotropin levels, cytogenetic and molecular analysis findings, complications, routes of delivery, and pregnancy outcomes were assessed.


RESULTS
All cases were diagnosed before 14 weeks' gestation by sonography. Only 1 ended with the delivery of a live-born neonate, whereas the other 5 cases required termination of pregnancy (TOP) before 21 weeks' gestation because of severe maternal complications (eg, preeclampsia, thyrotoxicosis, lung metastasis, and heavy bleeding) or intrauterine fetal death. The pathologic diagnosis of a complete hydatidiform mole was confirmed in all cases. Two patients required methotrexate for treatment of persistent trophoblastic disease (PTD).


CONCLUSIONS
On the basis of our experience, in cases with a normal karyotype and no gross fetal abnormalities on sonography, we carefully recommend continuation of pregnancy as long as maternal complications are absent or controllable. However, updated treatment criteria are still needed, and intensive maternal follow-up is necessary in the postpartum period because maternal complications during pregnancy and PTD after TOP are not uncommon.
Lee
Si Won
SW
Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, 1-19 Mukjeong Dong, Jung-gu, Seoul 100-380, Korea.
Kim
Moon Young
MY
Chung
Jin Hoon
JH
Yang
Jae Hyug
JH
Lee
Young Ho
YH
Chun
Yi Kyeong
YK
D000328:Adult; D003937:Diagnosis, Differential; D004200:Diseases in Twins / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000648:ultrastructure*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011379:Prognosis; D016216:Ultrasonography, Prenatal / Q000379:methods*