Table 4. Cases of trizygotic pregnancies consisting of complete mole and two co-existing twins.

Study	Age (y)	Conception	GA at delivery (wk)	Maternal complications	Pregnancy outcome	GTD	Postpartum therapy	Confirmation of diagnosis
Sauerbrei et al 14	23	Clomiphene	22	VB, PEC with severe features at 22 wk	Spontaneous abortion	No	MTX, ActD (5 cycles)	Postpartum by placental pathology and elevated hCG
Ohmichi et al 15	34	hMG-hCG	17	VB	Spontaneous abortion	PTT	N/A	Postpartum by placental pathology and elevated hCG
Azuma et al 16	24	hMG-hCG	19	VB	Spontaneous abortion	No	N/A	Postpartum by placental pathology
van de Geijn et al 24	31	GIFT	24	VB	PTL, SVD, neonatal deaths of both twins	No	N/A	Antepartum US findings and elevated hCG Confirmed postpartum
Shahabi et al 25	25	Clomiphene	17	Hyperthyroidism, hyperemesis	Induced abortion due to hyperemesis	Choriocarcinoma, pulmonary metastasis	MTX (2 cycles)	Antepartum US findings and elevated hCG Confirmed postpartum
Shozu et al 26	31	IVF-ET	15	VB	Induced abortion due to VB	Invasive mole	MTX, ActD (6 cycles)	Postpartum by pathology and DNA polymorphisms in placental tissue
Higashino et al 27	23	Clomiphene, hFSH-hCG	22	Hyperthyroidism, PEC with severe features, pulmonary edema	Induced abortion due to maternal status	Invasive mole	MTX (7 cycles), etoposide (2 cycles)	Antepartum US findings and elevated hCG Confirmed postpartum
Gray-Henry et al 28	31	Metrodin, hCG	16	Massive VB	Induced abortion due to life-threatening hemorrhage	No	N/A	Antepartum US findings and elevated hCG Confirmed postpartum
Amr et al 29	31	Clomiphene, hCG	30	None	PTL, SVD, neonatal death of 1 twin	No	N/A	Postpartum by placental pathology and elevated hCG
Rajesh et al 11	29	Spontaneous	24	VB	PTL, SVD, neonatal death of both twins	No	N/A	Antepartum US findings and elevated hCG Confirmed postpartum
Malhotra et al 12	29	Spontaneous	21	VB	Spontaneous abortion	No	N/A	Antepartum US findings and elevated hCG Confirmed postpartum
Takagi et al 30	37	hMG, hCG	28	Cerclage placed	PTL, CD for malpresentation, survival of both twins	Invasive mole, pulmonary metastases	MTX (6 cycles)	Antepartum US findings and elevated hCG Confirmed postpartum
Bovicelli et al 8	32	ICSI	31	VB	Emergency CD for nonreassuring fetal testing, IUFD of one twin (fetomaternal hemorrhage)	No	N/A	Antepartum US findings and elevated hCG CVS c/w all paternal genotype Confirmed postpartum
Steigrad et al 31	40	IVF	34	VB	CD due to VB, survival of both twins	Metastatic GTN, pulmonary metastases	MTX, FA (3 cycles)	Antepartum US findings and elevated hCG Confirmed postpartum
Ko et al 32	36	IVF-ET, donor embryo	33	PEC with severe features	CD due to PEC, survival of both twins	No	N/A	Antepartum US findings and elevated hCG Confirmed postpartum
This study	30	GnTp, IUI	16	HELLP	SAB of twin B, then induced abortion of twin A due to maternal status	Metastatic GTN, pulmonary metastases	MTX	Antepartum US findings and elevated hCG Confirmed postpartum (twin A unremarkable, twin B partial mole)

Abbreviations: ActD, actinomycin D; CD, cesarean delivery; EMA-CO, etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine; ET, embryo transfer; FA, folinic acid; GA, gestational age; GIFT, gamete intrafallopian transfer; GTD, gestational trophoblastic disease; GTN, gestational trophoblastic neoplasia; hCG, human chorionic gonadotropin; HEELP, hemolysis elevated liver enzymes low platelets syndrome; hFSH, human follicle stimulating hormone; hMG, human menopausal gonadotropin; ICSI, intracytoplasmic spermatic injection; IUFD, intrauterine fetal demise; IUI, intrauterine injection; IVF, in vitro fertilization; MTX, methotrexate; PEC, preeclampsia; PT, preterm; PTL, preterm labor; SAB, spontaneous abortion; SVD, spontaneous vaginal delivery; VB, vaginal bleeding.