Hydatidiform mole: Management
- Ross S Berkowitz, MD
Ross S Berkowitz, MD
- William H. Baker Professor of Gynecology
- Harvard Medical School
- Director of Gynecologic Oncology and Gynecology
- Brigham and Women's Hospital and Dana Farber Cancer Institute
- New England Trophoblastic Disease Center
- Donald Peter Goldstein, MD
Donald Peter Goldstein, MD
- Professor of Obstetrics, Gynecology, and Reproductive Biology
- Harvard Medical School
- Founder and Co-Director
- New England Trophoblastic Disease Center
- Neil S Horowitz, MD
Neil S Horowitz, MD
- Assistant Professor of Obstetrics, Gynecology, and Reproductive Biology
- Harvard Medical School
- Director of Clinical Research, Gynecologic Oncology
- Brigham and Women’s Hospital
- Section Editors
- Robert L Barbieri, MD
Robert L Barbieri, MD
- Editor-in-Chief — Obstetrics, Gynecology and Women's Health
- Section Editor — General Gynecology and Female Reproductive Endocrinology
- Kate Macy Ladd Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Department Chair, Gynecologic Oncology
- University of Washington Medical Center
- Deputy Editors
- Sandy J Falk, MD, FACOG
Sandy J Falk, MD, FACOG
- Director, Editorial Relations — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Instructor of Obstetrics, Gynecology and Reproductive Biology, Part-time
- Harvard Medical School
- Sadhna R Vora, MD
Sadhna R Vora, MD
- Deputy Editor — Oncology
- Instructor in Medicine
- Harvard Medical School
Hydatidiform mole (HM) is part of a group of diseases classified as gestational trophoblastic disease (GTD), which originate in the placenta and have the potential to locally invade the uterus and metastasize. The pathogenesis of GTD is unique because the maternal tumor arises from gestational rather than maternal tissue .
HM is made up of two distinct entities, complete hydatidiform mole and partial hydatidiform mole. These differ on the basis of chromosomal pattern, gross and microscopic histopathology, and clinical presentation and outcome [2-4]. Molar pregnancies, although benign, are considered to be premalignant because they have the capability of developing into a malignancy. Malignant disease is referred to as gestational trophoblastic neoplasia (GTN); the histologic entities included in this group are:
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- Uterine evacuation
- Patients at high risk for GTN
- - Hysterectomy
- - Prophylactic chemotherapy
- Rh(D) immune globulin
- MANAGEMENT OF COMPLICATIONS
- Ovarian theca lutein cysts
- Cardiopulmonary symptoms
- Serial hCG
- - Surveillance protocol
- Shorter duration of monitoring
- - Diagnosis of GTN
- - Persistent low hCG (quiescent GTN)
- Gestational trophoblastic neoplasia
- Subsequent pregnancy
- - Repeat molar pregnancy
- - Obstetric management
- SUMMARY AND RECOMMENDATIONS