Systematic Evaluation and Nursing Outlook of Clinical Characteristics of 60 Twin Pregnancies with Complete Hydatidiform Mole and a Coexistent Viable Foetus

Jing Yang; Zhan Shi; Shafeng Jia; Jia Liu; Ling Jiang; Yueqin Zhu

doi:10.2147/PPA.S428330

Systematic Evaluation and Nursing Outlook of Clinical Characteristics of 60 Twin Pregnancies with Complete Hydatidiform Mole and a Coexistent Viable Foetus

Patient Prefer Adherence. 2023 Oct 27:17:2631-2640. doi: 10.2147/PPA.S428330. eCollection 2023.

Authors

Jing Yang^#¹, Zhan Shi^#¹, Shafeng Jia^#¹, Jia Liu^#², Ling Jiang², Yueqin Zhu²

Affiliations

¹ Department of Obstetrics, Suzhou Municipal Hospital, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, People's Republic of China.
² Department of Nursing Department, Gusu School, Nanjing Medical University, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, People's Republic of China.

^# Contributed equally.

Abstract

Objective: To analyse the clinical data of and provide a reference for the care and perinatal health care of twin pregnancy patients with complete hydatidiform mole and a coexistent foetus (CHM & CF).

Methods: We searched the China National Knowledge Infrastructure (CNKI) and Wanfang and VIP databases to comprehensively collect clinical studies on the "clinical characteristics of complete hydatidiform mole and coexisting foetal twin pregnancy". Patients' data were extracted from the literature, and 60 patients were divided into Group A (live newborns not delivered, 47) and Group B (live newborns delivered, 13). The clinical characteristics of the two groups were compared to explore the pregnancy outcomes and influencing factors of persistent gestational trophoblastic disease (pGTD) in patients with CHM & CF.

Results: The gestational week of diagnosis (Odd Ratio (OR)=0.203, 95% Confidence Interval (CI)=0.055-0.753) and number of complications (OR=0.328, 95% CI=0.135-0.793) were found to be independent influencing factors of pregnancy outcomes in patients with CHM & CF (p < 0.05). Ovulation induction therapy (OR=2.333, 95% CI=0.561-9.708), preeclampsia (OR=75.000, 95% CI=11.041-509.486) and the number of complications (OR=4.768, 95% CI=1.914-11.875) were the independent influencing factors of developing pGTD (p < 0.05).

Conclusion: Pregnancy should not be terminated immediately after the early detection of CHM & CF, and multiple factors should be considered. Preeclampsia may indicate a poor prognosis, and ovulation induction may increase the incidence of pGTD. Targeted nursing and psychological nursing should be carried out according to the clinical symptoms of the patients.

Keywords: clinical characteristics; complete hydatidiform mole and coexistent foetus; nursing; persistent gestational trophoblastic disease; twin pregnancy.

Grants and funding

The project was supported by the Correlation between psychological stress at different stages of IVF-ET pregnancy and maternal and infant outcomes: a prospective cohort study (GSKY20220402).Funding agencies did not play a role in study design, data collection, analysis and interpretation, and manuscript writing.