April 5th, 2020

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Perinatal and Oncological Outcomes in Complete Hydatidiform Mole with Coexisting Fetus: A Series of 10 Cases and Literature Review
Authors:  Dan Wang, M.D., Fan Yu, M.D., Xinyan Liu, M.D., Juntao Liu, M.D., Xirun Wan, M.D., and Yang Xiang, M.D.
  OBJECTIVE: To describe the clinical features, management, pregnancy outcome, and oncological outcome of patients with complete hydatidiform mole with coexisting fetus (CHMCF).

STUDY DESIGN: From January 2001 to December 2016, patients with a diagnosis of CHMCF were treated in our hospital. Prenatal diagnosis, pregnancy outcome, and occurrence of persistent trophoblastic disease (PTD) were reviewed. Previously major reports of CHMCF were reviewed.

RESULTS: The mean gestational ages at diagnosis and at termination were 16+1 weeks and 20 weeks, respectively. The median level of serum β-hCG was 748,702.50 mIU/mL. Five patients chose to terminate pregnancy after diagnosis. One pregnancy was terminated due to severe vaginal bleeding and lung metastasis. Four patients elected to continue the pregnancy, and 2 of those delivered a live infant. Three patients developed PTD. Compared with single molar pregnancy, CHMCF was diagnosed at a later gestational age, with higher serum β-hCG. CHMCF seems not to increase the risk of PTD.

CONCLUSION: CHMCF needs to be differentiated from twin pregnancy with partial hydatidiform mole. CHMCF seems not to increase the risks of PTD compared with single molar pregnancy. It seems reasonable to continue the pregnancy when fetal anomalies and abnormal karyotype are excluded and in the presence of relatively stable clinical course without major complications.
Keywords:  gestational trophoblastic disease, hydatidiform mole, molar pregnancy, persistent trophoblastic disease, twin pregnancy
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