Twin Pregnancy with Complete Hydatidiform Mole: What are The Pregnancy Outcomes?
BACKGROUND AND PURPOSE:
Zilberman Sharon et al. (BJOG, 2020) assessed perinatal and obstetric outcomes when a complete hydatidiform mole (CHM) coexists with a normal fetus and placenta
Systematic review and meta-analysis (May 1980 through May 2019)
Observational cohort studies
Included studies needed to assess at least four cases that were confirmed by histopathology and provide data on pregnancy outcomes and GTN
Two reviewers independently reviewed abstracts and articles
14 studies | 244 cases
Live births: 50% | IUFD was reported in 40.1% of ongoing pregnancies | 78% of births were preterm
Incidence of maternal complication in ongoing pregnancies: 80.8%
Complications: Vaginal bleeding, hyperthyroidism, and preeclampsia
Total cases diagnosed with GTN: 34%
Risk was present regardless of gestational age at the time of termination or delivery
There was significant variability in reporting of complications between studies
Twin pregnancies that combine a CHM and a normal fetus are at a high risk of experiencing obstetric complications, including IUFD, pre‐eclampsia and preterm delivery
Approximately one third of cases will develop a GTN
The authors state that
Our findings emphasise the need for ongoing twin pregnancies including a CHM to be cared for by a multidisciplinary team in a centre with access to neonatal intensive care for very premature newborns and to be offered post‐pregnancy follow up in a centre specialising in the management of GTN
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan