Molar pregnancies

Molar pregnancies (MPs; hydatidiform moles) are chromosomally abnormal pregnancies that have the potential to become malignant.

There is a higher possibility of MP in women less than 20 years of age or over 35 years of age, and in those who have experienced MP in a previous pregnancy.

The most common presenting symptom is vaginal bleeding.

Suction evacuation (electrical or manual) is the preferred management option in women who desire preservation of fertility.

Hysterectomy may be considered in women who do not want to preserve fertility.

The risk of postmolar neoplasm is 15% to 20% for those with complete hydatidiform mole and 1% to 5% for those with partial hydatidiform mole.

Over 95% of women with postmolar gestational trophoblastic neoplasia attain remission, often with preservation of fertility.

Molar pregnancies (hydatidiform moles) are chromosomally abnormal pregnancies that have the potential to become malignant (gestational trophoblastic neoplasia). If a MP or other conception gives rise to a persistent locally invasive and/or metastatic trophoblastic tumor, this is considered to be gestational trophoblastic neoplasia (GTN). Gestational trophoblastic disease includes tumors, such as hydatidiform moles and GTN, arising from placental trophoblasts. Syncytiotrophoblasts secrete human chorionic gonadotropin and, therefore, this hormonal product is used as a tumor marker for the disease.[1]Hancock BW. Staging and classification of gestational trophoblastic disease. Clin Obstet Gynecol Best Pract Res. 2003 Dec;17(6):869-83. http://www.ncbi.nlm.nih.gov/pubmed/14614886?tool=bestpractice.com [2]Eiriksson L, Dean E, Sebastianelli A, et al. Guideline no. 408: management of gestational trophoblastic diseases. J Obstet Gynaecol Can. 2021 Jan;43(1):91-105.e1. https://www.jogc.com/article/S1701-2163(20)30222-X/fulltext http://www.ncbi.nlm.nih.gov/pubmed/33384141?tool=bestpractice.com [3]Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13. https://www.gynecologiconcology-online.net/article/S0090-8258(21)01421-9/fulltext http://www.ncbi.nlm.nih.gov/pubmed/34686354?tool=bestpractice.com ​​​​​​