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Human Reproduction, Vol. 15, No. 3, 608-611, March 2000
© 2000 European Society of Human Reproduction and Embryology

Hydatidiform mole coexistent with a twin live fetus: a national collaborative study in Japan

Hideo Matsui1,5, Souei Sekiya1, Tamotsu Hando2, Norio Wake3 and Yutaka Tomoda4

1 Department of Obstetrics and Gynecology, Chiba University School of Medicine, Inohana 1–8–1, Chuo-ku, Chiba 260-8670, 2 Department of Perinato-Gynecology, Kagawa Medical University, Kagawa 761-0701, 3 Department of Reproductive Physiology and Endocrinology, Medical Institute of Bioregulation Kyushu University, Oita 874-0000 and 4 Department of Obstetrics and Gynecology, Nagoya University School of Medicine,Nagoya 466-0065, Japan

A national collaborative study was conducted in Japan to evaluate the clinical course and the sequelae of patients with hydatidiform mole coexistent with twin live fetus (HMTF). Seventy-two cases of HMTF were diagnosed based on gross appearance and histopathological criteria. In 18 cases, the molar parts were cytogenetically confirmed to be of androgenetic origin (complete mole). The overall incidence of persistent trophoblastic tumour (PTT) in patients with HMTF was 30.6%, and it increased to 50.0% in the 18 patients with proven androgenetic complete mole coexistent with twin live fetus (CHMTF). Among these patients, the mean gestational age at termination of pregnancy or delivery in those who developed PTT (n = 9) and those who did not (n = 9) were 20.6 and 19.4 weeks respectively. The incidence of severe maternal complications was significantly higher in patients who subsequently developed PTT (P < 0.05). The rate of subsequent development of PTT in patients with CHMTF was found to be considerably higher than in a previous study of patients with single complete mole (50 and 12.5% respectively). However, since the risk of malignancy is unchanged with advancement of gestational age, continued pregnancy may be allowed in patients with HMTF provided that severe maternal complications are controlled and fetal karyotype and development are normal.

Key words: coexistent fetus/hydatidiform mole/persistent trophoblastic disease/twin pregnancy

5 To whom correspondence should be addressed


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