Obstetrics outcomes after complete and partial molar pregnancy: Review of the literature and meta-analysis. (April 2021)

• Record Type: Journal Article
• Authors: Capozzi, Vito Andrea; Butera, Diana; Armano, Giulia; Monfardini, Luciano; Gaiano, Michela; Gambino, Giulia; Sozzi, Giulio; Merisio, Carla; Berretta, Roberto
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 259(2021)
• Page Start: 18
• Page End: 25
• Publication Date: 2021-04
• Subjects: Molar pregnancy -- Partial hydatiform mole -- Complete hydatiform mole -- Obstetrics outcomes; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2021.01.051
• Languages: English
• ISSNs: 0301-2115

Abstract

Highlights: Live births after CHM was statistically higher compared to live births after PHM. Partial molar recurrence occurred more frequently after PHM than CHM. There was no significant difference in adverse obstetric outcomes between CHM and PHM. Abstract: The hydatidiform mole is a rare gynecological disease rising from the trophoblastic. Post-molar pregnancies have an extremely variable course, varying from repeated abortions, stillbirths, preterm births, live births, or recurring in further molar pregnancies. Literature on obstetric outcomes following molar pregnancy is poor, often including monocentric studies, and with data collected from national databases. This review and meta-analysis aim to analyze the obstetric outcomes after conservative management of complete (CHM) and partial (PHM) molar pregnancies. The meta-analysis was performed following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA). Six studies met the inclusion. Of the total 25, 222 patients, 13, 129 complete (52.1 %) and 12, 093 partial (47.9 %) molar pregnancies were included. Live births rate after CHM was statistically higher (p = 0.002) compared to the live births after PHM (53.6 % vs. 51.0 %, 3266 vs. 1807 cases, respectively). Studies showed heterogeneity I 2 = 57.7 %, pooled proportion = 0.2 %, and 95 % Confidence Interval (CI) 0.6 to 0.9. No statistically significant difference was demonstrated for ectopic pregnancies (p = 0.633), miscarriage (p = 0.637), preterm birth (p = 0.865), stillbirth (p = 0.911), termination of pregnancy (p = 0.572), and complete molar recurrence (p = 0.580) after CHM and PHM. Partial molar recurrence occurred more frequently after PHM than CHM (0.4 % vs. 0.3 %, 52 vs. 37 cases, respectively, p = 0.002). Careful counseling on the obstetric subsequent pregnancies outcomes should be provided to patients eager for further pregnancy and further studies are needed to confirm these results.