Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct;60(5):698-703.
doi: 10.1111/ajo.13130. Epub 2020 Feb 17.

Pre-operative classification of molar pregnancy: How good is ultrasound?

Nicole Stamatopoulos  1 , Mercedes Espada Vaquero  1 , Mathew Leonardi  1 , Batool Nadim  2 , Amber Bailey  2 , George Condous  1
Affiliations

Pre-operative classification of molar pregnancy: How good is ultrasound?

Nicole Stamatopoulos et al. Aust N Z J Obstet Gynaecol. 2020 Oct.

Abstract

Background: Histopathology is the reference standard for diagnosing hydatidiform molar pregnancy (HMP).

Aim: To assess the performance of pre-operative transvaginal ultrasound (TVS) to predict HMP.

Materials and methods: A retrospective diagnostic accuracy study was performed on women who had both TVS and histopathological examination of uterine curettings between January 2011-February 2017. TVS diagnosis of partial MP (PMP) included assessment of fetal parts and/or empty gestational sac with small cystic spaces adjacent to gestational sac. TVS diagnosis of complete MP (CMP) included assessment of complex, echogenic intra-uterine mass(es) containing multiple small cystic areas. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios (PLR/NLR) for TVS were reported. Reference standard was histology.

Results: There were 4917 consecutive women who underwent TVS; 1636 underwent surgical curettage for miscarriage. Forty out of 4917 (0.6%) had HMP histologically; 25/40 (62.5%) had suspected HMP and 15/40 (37.5%) did not; 24/40 (60.0%) had CMP of which 19/24 (79.1%) were suspected on TVS and 5/24 (20.8%) were not; 16/40 (40.0%) had PMP of which 6/16 (37.5%) were suspected on TVS and 10/16 (62.6%) were not. The sensitivity, specificity, PPV, NPV, PLR and NLR of pre-operative TVS to predict HMP were: 60.0, 99.1, 63.2, 99.0% 68.4, 0.4; for CMP: 79.2, 99.8, 86.3, 99.6%, 421.7, 0.2; for PMP: 37.5, 99.3, 35.3, 99.4%, 54.3, 0.6.

Conclusion: Histology remains the gold standard for diagnosing HMP. TVS is an acceptable diagnostic tool for HMP. When there are no ultrasound features of HMP, almost all these women will not have an underlying HMP.

Keywords: early pregnancy; gestational trophoblastic disease; miscarriage; molar pregnancy; transvaginal ultrasound.

PubMed Disclaimer

References

    1. Royal College of Obstetricians and Gynaecologists. The Management of Gestational Trophoblastic Disease. RCOG Greentop. London: RCOG, 2010.
    1. Sebire NJ, Fisher RA, Rees HC. Histopathological diagnosis of partial and complete hydatidiform mole in the first trimester of pregnancy. Pediatr Dev Pathol 2003; 6: 69-77.
    1. Jain KA. Gestational trophoblastic disease. Ultrasound Q 2005; 21: 245-253.
    1. Thomas CMG, Kerkmeijer LGW, Massuger LFAG, ten Kate-Booij MJ, Sweep FCGJ. Earlier diagnosis and serum human chorionic gonadotropin regression in complete hydatidiform moles. Obstet Gynecol. 2009; 113: 326-331.
    1. Kirk E, Papageorghiou AT, Condous G, Bottomley C, Bourne T. The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole. Ultrasound Obstet Gynecol 2007; 29: 70-75.

LinkOut - more resources