Outcomes of complete hydatidiform mole coexistent with live fetus following assisted reproductive technologies: A retrospective study

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.