Introduction/Background*Partial molar pregnancy with a coexisting fetus (PHMCF) is a very rare entity leading to limited understanding of its natural course and optimal diagnostics and treatment. The aim of this study was to describe a case series of patients with PHMCF and to review the current available literature.
Methodology We searched the databases of the Charing Cross Trophoblastic Disease Center and the Dutch Working Party on Trophoblastic Tumors. Secondly, we performed a systematic literature review to evaluate the incidence of PHMCF, the clinical presentation, obstetrical and maternal outcomes of a pregnancy complicated by PHMCF.
Result(s)*Fifteen patients with PHMCF were extracted from the databases and ninety-four case-reports from literature. Vaginal bleeding and hypertensive disorders occur more often during a PHMCF pregnancy compared to normal pregnancies (27% and 18%), especially the incidence of severe early pre-eclampsia (PE) was high in case of fetal triploidy (41%). The incidence of progression into gestational trophoblastic neoplasia (GTN) was 13%. High numbers of premature delivery and termination of pregnancy in case of fetal triploidy led to a neonatal survival of only 26%.
Conclusion*Fetal triploidy has a poor prognosis and higher chance of maternal complications. Termination of pregnancy is therefore often advisable. In case of normal pregnancy in combination of a partial mole, continuation of pregnancy is possible in combination with close guidance and clinical monitoring preferably in obstretric high care units because of the high maternal and fetal risks.
Disclosures None of the authors has a conflict of interest. There was no funding for this study.
• Department of Gynecologic oncology, Center Gynecologic Oncology Amsterdam, location The Netherlands Cancer Institute – Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
Department of Medical Oncology, Charing Cross Gestational Trophoblastic Disease Centre, Charing Cross Hospital Campus of Imperial College, London W68RF, United Kingdom
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