Aim: To evaluate the reproductive and obstetric outcomes after complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) in a tertiary referral center.

Materials and Methods: This retrospective cohort included 90 women with histologically confirmed molar pregnancy (65 CHM and 25 PHM) who were managed between 2015 and 2024. Cases with ectopic localization, uncertain diagnosis, missing essential data, or insufficient follow-up were excluded. Women with uterine preservation, no permanent contraception, reproductive age, and adequate follow-up were defined as the subgroup with potential for subsequent pregnancy and were included in the reproductive outcome analysis. Postmolar gestational trophoblastic neoplasia (GTN), occurrence of at least one subsequent pregnancy, outcomes of the first postmolar pregnancy, and obstetric outcomes of the first live birth were compared between CHM and PHM.

Results: Among women with potential for subsequent pregnancy (43 CHM and 14 PHM), at least one subsequent pregnancy occurred in 22 (51.2%) and 8 (57.1%) women, respectively (p=0.697). When only the first subsequent pregnancy was considered, live birth, miscarriage, and recurrent molar pregnancy rates did not differ significantly between CHM and PHM groups (live birth: 63.6% vs 87.5%, p=0.374; miscarriage: 18.2% vs 12.5%, p=1.000; recurrent mole: 18.2% vs 0%, p=0.550). Obstetric outcomes of the first subsequent live birth were also comparable between groups, including gestational age at delivery (p=0.336), birthweight (p=0.924), Apgar scores (all p>0.05), and mode of delivery (p=1.000); all deliveries occurred at term. Fetal growth restriction, preeclampsia, uterine atony, and oligohydramnios did not differ significantly between groups (all p>0.05). No cases of preterm premature rupture of membranes (PPROM), premature rupture of membranes (PROM), placenta previa, placenta accreta spectrum, or placental abruption were observed.

Conclusion: In this single-center cohort, fertility potential and obstetric outcomes appeared generally favorable after both CHM and PHM. However, subgroup comparisons should be interpreted cautiously, as the limited sample size, particularly in the PHM group, may have reduced the statistical power to detect meaningful between-group differences.

Keywords: gestational trophoblastic disease, hydatidiform mole, postmolar pregnancy, pregnancy outcome, reproductive outcome