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Volume 61
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Systematic Review

Hydatidiform Mole with Coexisting Normal Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis

by
Pier Carlo Zorzato
1,
Alberta Ricci
1,
Mariachiara Bosco
1,
Liliana Galli
1,
Laura Luka
1,
Irene Porcari
1,
Rosa Maria Laterza
2,3,
Veronica Parolin
4,
Michele Milella
4,
Antonio Simone Laganà
5,
Benjamim Ficial
6,
Chiara Casprini
1,
Anna Festi
1,
Stefano Uccella
1,* and
Simone Garzon
1
1
Unit of Obstetrics and Gynecology, Department of Surgery, Dentistry, Pediatrics, and Gynecology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Piazzale A. Stefani 1, 37125 Verona, Italy
2
Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
3
Karl Landsteiner Society for Special Gynecology and Obstetrics, 1090 Vienna, Austria
4
Section of Innovation Biomedicine-Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, 37125 Verona, Italy
5
Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
6
Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, 37125 Verona, Italy
*
Author to whom correspondence should be addressed.
Medicina 2025, 61(10), 1781; https://doi.org/10.3390/medicina61101781
Submission received: 31 July 2025 / Revised: 8 September 2025 / Accepted: 25 September 2025 / Published: 1 October 2025
(This article belongs to the Section Obstetrics and Gynecology)
Versions Notes

Abstract

Background and Objectives: This study aimed to evaluate obstetric, neonatal, and oncologic outcomes of pregnancies complicated by a hydatidiform mole coexisting with a live fetus (HMCF) carried beyond viability, and to assess the impact of delivery mode on outcomes. Materials and Methods: A systematic review and individual participant data meta-analysis included HMCF cases progressing beyond 23 weeks. Obstetric and neonatal outcomes, delivery patterns, and oncologic risks were analyzed. Results: Among 118 pregnancies complicated by HMFC (124 newborns), most were complete moles (87%). Median delivery occurred at 31.6 weeks, with over half before 32 weeks. Common complications included vaginal bleeding (59%), preeclampsia (30%), and hyperthyroidism (18%). Cesarean delivery was performed in 79% of cases, often for mole-related factors, but was not associated with reduced maternal or oncologic risk. Neonatal deaths occurred exclusively in infants delivered ≤32 weeks, highlighting extreme prematurity as the key determinant of survival. Severe preeclampsia was strongly linked to earlier delivery. Conclusion: With close monitoring, continuation of HMCF pregnancies is possible. Neonatal mortality is mainly driven by prematurity, which appears to be an indirect consequence of HMFC through the development of mola-associated complications. Cesarean section does not appear to improve maternal and oncologic outcomes. Vaginal delivery can be considered when no standard contraindications exist.
Keywords: twin pregnancy; complete mole; hydatidiform pregnancy; delivery mode; obstetric management twin pregnancy; complete mole; hydatidiform pregnancy; delivery mode; obstetric management

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MDPI and ACS Style

Zorzato, P.C.; Ricci, A.; Bosco, M.; Galli, L.; Luka, L.; Porcari, I.; Laterza, R.M.; Parolin, V.; Milella, M.; Laganà, A.S.; et al. Hydatidiform Mole with Coexisting Normal Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis. Medicina 2025, 61, 1781. https://doi.org/10.3390/medicina61101781

AMA Style

Zorzato PC, Ricci A, Bosco M, Galli L, Luka L, Porcari I, Laterza RM, Parolin V, Milella M, Laganà AS, et al. Hydatidiform Mole with Coexisting Normal Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis. Medicina. 2025; 61(10):1781. https://doi.org/10.3390/medicina61101781

Chicago/Turabian Style

Zorzato, Pier Carlo, Alberta Ricci, Mariachiara Bosco, Liliana Galli, Laura Luka, Irene Porcari, Rosa Maria Laterza, Veronica Parolin, Michele Milella, Antonio Simone Laganà, and et al. 2025. "Hydatidiform Mole with Coexisting Normal Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis" Medicina 61, no. 10: 1781. https://doi.org/10.3390/medicina61101781

APA Style

Zorzato, P. C., Ricci, A., Bosco, M., Galli, L., Luka, L., Porcari, I., Laterza, R. M., Parolin, V., Milella, M., Laganà, A. S., Ficial, B., Casprini, C., Festi, A., Uccella, S., & Garzon, S. (2025). Hydatidiform Mole with Coexisting Normal Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis. Medicina, 61(10), 1781. https://doi.org/10.3390/medicina61101781

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