Ulrika Joneborg1, Lena Marions2. 1. Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet/Karolinska University Hospital, Stockholm, Sweden. ulrika.joneborg@karolinska.se 2. Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet/Karolinska University Hospital, Stockholm, Sweden.
Abstract
OBJECTIVE: To describe the current clinical presentation of complete (CHM) and partial (PHM) hydatidiform mole in a Swedish setting. STUDY DESIGN: A retrospective analysis of medical charts from 331 women with hydatidiform mole (HM) between 1991 and 2010 was performed. Demographics and clinical features were analyzed, and symptoms in women with CHM were compared to those from a historic group (1988 to 1993) from the New England Trophoblastic Disease Center. RESULTS: In women with CHM, bleeding was more common than in women with PHM (57% vs. 41%, p < 0.001) but significantly less common as compared to the historic group (84%). Women with CHM and PHM were diagnosed before the onset of symptoms in 32% and 53%, respectively, compared to the previously reported 10% (p < 0.001). There was a significantly higher proportion of women 240 years of age with CHM than with PHM (23% vs. 7%). Ultrasound predicted the molar diagnosis in 73% of CHMs and 35% of PHMs (p < 0.001). CONCLUSION: In our study a large proportion of molar pregnancies were asymptomatic at the time of diagnosis. This confirms earlier reports of the changing clinical presentation of HM and shows that this trend continues. Age, ultrasound findings and hCG levels can add valuable information.
OBJECTIVE: To describe the current clinical presentation of complete (CHM) and partial (PHM) hydatidiform mole in a Swedish setting. STUDY DESIGN: A retrospective analysis of medical charts from 331 women with hydatidiform mole (HM) between 1991 and 2010 was performed. Demographics and clinical features were analyzed, and symptoms in women with CHM were compared to those from a historic group (1988 to 1993) from the New England Trophoblastic Disease Center. RESULTS: In women with CHM, bleeding was more common than in women with PHM (57% vs. 41%, p < 0.001) but significantly less common as compared to the historic group (84%). Women with CHM and PHM were diagnosed before the onset of symptoms in 32% and 53%, respectively, compared to the previously reported 10% (p < 0.001). There was a significantly higher proportion of women 240 years of age with CHM than with PHM (23% vs. 7%). Ultrasound predicted the molar diagnosis in 73% of CHMs and 35% of PHMs (p < 0.001). CONCLUSION: In our study a large proportion of molar pregnancies were asymptomatic at the time of diagnosis. This confirms earlier reports of the changing clinical presentation of HM and shows that this trend continues. Age, ultrasound findings and hCG levels can add valuable information.