title: Complicating preeclampsia as a predictor of poor survival of the fetus in complete hydatidiform mole coexistent with twin fetus.
abstract: OBJECTIVE
  To examine whether preeclampsia is a predictive factor for fetal prognosis in complete hydatidiform mole coexistent with twin fetus (CHMCF).
  
  
  METHODS
  We performed a retrospective chart review for 17 cases of definitive CHMCF managed in our hospital between 1991 and 2011.
  
  
  RESULTS
  Fifteen patients chose expectant management and the remaining 2 selected termination of the pregnancy. During expectant management 6 patients displayed hypertension with proteinuria, representing preeclampsia, by the 2nd trimester (11-24 weeks) and the other 9 did not (nonpreeclamptic). No babies from preeclamptic mothers survived, with 5 intrauterine fetal deaths at 16-29 weeks and 1 neonatal death at 22 weeks. By contrast, 5 babies from 9 nonpreeclamptic mothers (1 preterm delivery at 29 weeks and 4 term deliveries) survived, while 4 pregnancies were lost by spontaneous abortion at 11-19 weeks. Low-risk gestational trophoblastic neoplasia (GTN) eventually occurred in both preeclamptic (4 of 6) and nonpreeclamptic (4 of 11) cases. Complicating preeclampsia correlated significantly with fetal demise and an increasing trend in serum hCG level but not with postmolar GTN.
  
  
  CONCLUSIONS
  Complicating preeclampsia predicts poor survival of the fetus, but not subsequent GTN, in CHMCF.
authors: Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Maki
authors: M
authors: Kihara
authors: Hirokazu
authors: H
authors: Usui
authors: Hirokazu
authors: H
authors: Tanaka
authors: Hiromi
authors: H
authors: Inoue
authors: Hideo
authors: H
authors: Matsui
authors: Makio
authors: M
authors: Shozu
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000032:Abortion, Therapeutic; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D031901:Gestational Trophoblastic Disease / Q000150:complications; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications*; D050498:Live Birth; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D059285:Pregnancy, Twin; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000150:complications*; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin