{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:15:06Z","timestamp":1788542106669,"version":"build-2803163510"},"reference-count":96,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Medicina"],"abstract":"<jats:p>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 \u226432 weeks, highlighting extreme prematurity as the key determinant of survival. Severe preeclampsia was strongly linked to earlier delivery. Conclusions: 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.<\/jats:p>","DOI":"10.3390\/medicina61101781","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:20:38Z","timestamp":1759332038000},"page":"1781","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hydatidiform Mole with Coexisting Normal Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis"],"prefix":"10.3390","volume":"61","author":[{"given":"Pier Carlo","family":"Zorzato","sequence":"first","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberta","family":"Ricci","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2109-6182","authenticated-orcid":false,"given":"Mariachiara","family":"Bosco","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0554-3974","authenticated-orcid":false,"given":"Liliana","family":"Galli","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Luka","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Porcari","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4772-1468","authenticated-orcid":false,"given":"Rosa Maria","family":"Laterza","sequence":"additional","affiliation":[{"name":"Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Karl Landsteiner Society for Special Gynecology and Obstetrics, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Parolin","sequence":"additional","affiliation":[{"name":"Section of Innovation Biomedicine-Oncology Area, Department of Engineering for Innovation Medicine (DIMI), Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, 37125 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Milella","sequence":"additional","affiliation":[{"name":"Section of Innovation Biomedicine-Oncology Area, Department of Engineering for Innovation Medicine (DIMI), Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, 37125 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-2802","authenticated-orcid":false,"given":"Antonio Simone","family":"Lagan\u00e0","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, \u201cPaolo Giaccone\u201d Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamim","family":"Ficial","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, 37125 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Casprini","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Festi","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4456-0822","authenticated-orcid":false,"given":"Stefano","family":"Uccella","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5840-699X","authenticated-orcid":false,"given":"Simone","family":"Garzon","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.1097\/IGC.0000000000000294","article-title":"Trophoblastic disease review for diagnosis and management a joint report from the international society for the study of trophoblastic disease, european organisation for the treatment of trophoblastic disease, and the gynecologic cancer intergroup","volume":"24","author":"Mangili","year":"2014","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1159\/000448139","article-title":"Prenatal Diagnosis of Twin Pregnancies with Complete Hydatidiform Mole and Coexistent Normal Fetus: A Series of 13 Cases","volume":"82","author":"Giorgione","year":"2017","journal-title":"Gynecol. Obstet. 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