title: Clinical findings of multiple pregnancy with a complete hydatidiform mole and coexisting fetus.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, 1-19 Mukjeong Dong, Jung-gu, Seoul 100-380, Korea.
authors.forename: Si Won
authors.initials: SW
authors.lastname: Lee
authors.forename: Moon Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Jin Hoon
authors.initials: JH
authors.lastname: Chung
authors.forename: Jae Hyug
authors.initials: JH
authors.lastname: Yang
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Yi Kyeong
authors.initials: YK
authors.lastname: Chun
mesh_terms: 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*