Diagnosis and Management of Molar Pregnancies

Abstract

Complete and partial molar pregnancies arise from abnormal fertilization with marked proliferation of syncytiotrophoblasts. Earlier diagnosis has reduced the frequency of severe medical complications at presentation; however, the risk of progression to gestational trophoblastic neoplasia (GTN) has remained unchanged. Initial assessment should include serum hCG measurement after physical examination, laboratory testing for organ dysfunction, and Doppler ultrasound. Following uterine evacuation, pathologic assessment can distinguish complete from partial moles or non-molar gestations. Close surveillance is essential for the timely diagnosis of GTN. Cure rates and subsequent obstetrics outcomes are excellent, but all patients should be referred for psychologic support and expert level care.

Keywords: Complete hydatidiform mole; Diagnosis; Gestational trophoblastic disease; Gestational trophoblastic neoplasia; Human chorionic gonadotropin; Molar pregnancy; Partial hydatidiform mole; Ultrasound.