Initial management of hydatidiform mole.

From July 1, 1969 to June 30, 1985, 381 patients received primary management for hydatidiform mole at Los Angeles County-University of Southern California Medical Center Women's Hospital. Three hundred fifty-eight of these women had complete records available for analysis. Of these, 277 women (77.4%) underwent suction curettage to remove the hydatidiform mole. Sharp curettage (41 patients, 11.5%), Pitocin (15, 4.2%), hysterectomy (12, 3.4%), prostaglandins (10, 2.8%), and hysterotomy (1, 0.3%) were used less frequently. Two patients (0.6%) had no therapy after spontaneous expulsion of a mole. Complications including infection, toxemia of pregnancy, anemia or hemorrhage, and postevacuation respiratory insufficiency were recorded in 242 patients (67.6%). This experience documents that hydatidiform mole is a high-risk pregnancy that requires prompt and intensive management. Suction curettage of the uterus is clearly the best means of management in most cases.