Outcomes of complete hydatidiform mole coexistent with live fetus
following assisted reproductive technologies: A retrospective study
Abstract
Objective To investigate the etiology of complete hydatidiform mole
coexistent with live fetus (CHMCF) following assisted reproductive
technologies (ART). Design Retrospective study. Setting Peking
University Third Hospital and tertiary reference. Population Total of 47
patients conceived via ART and diagnosed with CHMCF, including 5 cases
from our hospital and 42 cases from literature. Methods Retrospective
analysis of risk factors associated with neonatal outcome and the
progression of gestational trophoblastic neoplasia (GTN). Main Outcome
Measures Pregnancy complications. Results Vaginal bleeding presented as
the most common complication (75%). The average gestational age
confirming diagnosis by ultrasound was 15.9±4.7 weeks. 40.4% of the
patients progressed to GTN. 41.5% of those who chose to continue
pregnancy had a favorable fetal outcome. Hyperemesis gravidarum and
abdominal pain had a 33.3% and 25% occurrence rate in not surviving
baby group, respectively, but not presented in surviving baby group.
Hypertension emerged in a significantly earlier gestational week in not
surviving baby group than the other (17.0±2.4 vs 25.3±2.3, p=0.003) .
Patients who progressed to GTN had a statistically higher rate of
abdominal pain (26.3% vs 3.6%, p=0.033) compared to those who did not.
Conclusions For CHMCF patients via ART, the surviving baby rate is
41.5% and the GTN progression rate is 40.4%, and appearance of
hyperemesis gravidarum, abdominal pain and early emerge of hypertension
predicted an adverse pregnancy outcome. Occurrence of abdominal pain and
early presentation of vaginal bleeding indicated a poor prognosis in GTN
progression.