Changes of clinical features in hydatidiform mole: analysis of 113 cases

Abstract

Objective: To investigate the changes of the clinical features of hydatidiform mole.

Study design: A total of 113 cases of hydatidiform mole treated in Peking Union Medical College Hospital during 1989-2006 were reviewed retrospectively, and a comparison was made to historic data from 1948-1975 using the chi2 test.

Results: The median age was 28 years (range, 20-55). The median gestational age was 90.2 days. Vaginal bleeding remains the most common presenting symptom, occurring in 94 of 113 cases (83.2%). Of 113 cases, 52 (46%) presented with excessive uterine size. Preeclampsia, hyperemesis, hemoptysis and theca lutein cysts occurred in 4 of 113 (3.5%), 12 of 113 (10.6%), 4 of 113 (3.5%) and 19 of 113 cases (16.8%), respectively. The incidence of postmolar trophoblastic neoplasia was 21% (24 of 113). Compared to historic data, the incidence of vaginal bleeding and preeclampsia were statistically lower (p < 0.005). The incidence of postmolar gestational trophoblastic neoplasia was increased moderately without statistical significance compared to historic data.

Conclusion: Because of the wide use of ultrasonography and serum human chorionic gonadotropin test, current patients with hydatidiform mole have been diagnosed earlier in gestation and the clinical features have changed. Patterns of medical practice should be changed as well.