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Related Experiment Videos

Complete hydatidiform mole and surviving coexistent twin

R E Bristow1, J B Shumway, A N Khouzami

  • 1Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, Baltimore, Maryland, USA.

Obstetrical & Gynecological Survey
|December 1, 1996
PubMed
Summary

Twin gestations with a complete hydatidiform mole and fetus are rare. Fetal survival is linked to less aggressive molar growth, not advanced gestational age, reducing the risk of persistent gestational trophoblastic tumor.

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Area of Science:

  • Reproductive Medicine
  • Gynecologic Oncology

Background:

  • Twin gestations with a complete hydatidiform mole and coexisting fetus are rare.
  • These pregnancies carry an increased risk of persistent gestational trophoblastic tumor (GTT).

Purpose of the Study:

  • To analyze clinical characteristics differentiating pregnancies with complete hydatidiform mole and coexisting fetus that result in fetal survival versus those requiring early evacuation.
  • To determine risk factors for persistent GTT in these specific twin gestations.

Main Methods:

  • A literature review of 25 cases was combined with an additional case.
  • Cases were categorized into two groups: previable (evacuated before fetal viability) and viable (resulting in a surviving infant).
  • Clinical data including maternal age, gestational age, uterine size discrepancy, and serum hCG levels were compared between groups.

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Main Results:

  • The viable group had a significantly later gestational age at evacuation (33.0 vs. 18.6 weeks) and smaller uterine size discrepancy (1.0 vs. 8.1 weeks).
  • Preevacuation serum hCG levels were significantly lower in the viable group (167,883 vs. 1,078,416 mIU/liter).
  • Persistent GTT occurred in 28.6% of the viable group versus 68.4% of the previable group (P = .09).

Conclusions:

  • Fetal survival in twin gestations with complete hydatidiform mole and coexisting fetus is associated with clinical indicators of less aggressive molar growth.
  • Achieving fetal viability does not independently increase the risk of developing persistent GTT.