{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:58:39Z","timestamp":1791845919231,"version":"4.3.4"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,5,17]],"date-time":"2020-05-17T00:00:00Z","timestamp":1589673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Epidemiological data on obstetric and oncologic complications in twin pregnancies combining a complete hydatidiform mole (CHM) coexisting with a normal fetus and placenta are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate perinatal and obstetric outcomes for mother and fetus and risk of gestational trophoblastic neoplasia (GTN) in twin pregnancies including a CHM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>PubMed, MEDLINE and EMBASE and the grey literature were searched for articles published between May 1980 and May 2019 using a protocol designed a priori and registered on PROSPERO (CRD42018112524).<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Observational cohort studies of four or more cases confirmed by histopathology and providing data on pregnancy outcomes and GTN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two reviewers independently reviewed abstracts and full\u2010text articles. The quality of the studies was assessed with the Newcastle\u2010Ottawa scale and a meta\u2010analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Of the 344 abstracts identified, 14 studies (244 cases) met the eligibility criteria. The incidence of maternal complication in ongoing pregnancies was 80.8% and included vaginal bleeding, hyperthyroidism and pre\u2010eclampsia. There were overall 91 (50%) live births in ongoing pregnancies and 83 (34%) of the total cases were subsequently diagnosed with GTN. Substantial and significant (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) heterogeneity was found for the incidence of preeclampsia indicating variability in reporting the incidence of some obstetric complications between studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients diagnosed with a twin pregnancy combining a CHM and an apparently normal fetus have a high risk of perinatal complications, low live\u2010birth rates and around a third of them will develop a GTN and should be managed by specialised multidisciplinary teams.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Our study indicates a high rate of obstetric and oncologic complications in patients presenting with a complete hydatidiform mole and coexistent normal fetus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16283","type":"journal-article","created":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T20:30:28Z","timestamp":1588019428000},"page":"1450-1457","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Obstetric outcomes of twin pregnancies presenting with a complete hydatidiform mole and coexistent normal fetus: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6834-2718","authenticated-orcid":false,"given":"N","family":"Zilberman Sharon","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center) Zerifin Israel"},{"name":"Affiliated with the Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Maymon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center) Zerifin Israel"},{"name":"Affiliated with the Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Melcer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center) Zerifin Israel"},{"name":"Affiliated with the Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0925-7737","authenticated-orcid":false,"given":"E","family":"Jauniaux","sequence":"additional","affiliation":[{"name":"Faculty of Population Health Sciences EGA Institute for Women\u2019s Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,17]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"113","article-title":"Twin pregnancy; hydatidiform mole associated with normal ovum; abortion at four months","volume":"7","author":"Luker G","year":"1914","journal-title":"Proc R Soc Med"},{"key":"e_1_2_8_3_1","first-page":"147","article-title":"Clinical features of multiple conception with partial or complete molar pregnancy and coexisting fetuses","volume":"39","author":"Steller MA","year":"1994","journal-title":"J Reprod Med"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199109000-00001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1272"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/268633a0"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60280-2"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.07.116"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12615"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.05.002"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.09010017.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2017.12.008"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.09.036"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dey242"},{"key":"e_1_2_8_15_1","first-page":"1","article-title":"Births: final data for 2017","volume":"67","author":"Martin JA","year":"2018","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-2082-9"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17470"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.006"},{"key":"e_1_2_8_19_1","unstructured":"GA WellsBS O\u2019ConnellD PetersonJ WelchV LososM TugwellP.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses.2005. 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