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422 New challenges in the management and follow-up of molar pregnancy
  1. Anca Copos,
  2. Diana Mocuta,
  3. Romina Cuc and
  4. Cristina Aur
  1. County Emergency Clinical Hospital of Oradea; University of Oradea, Faculty of Medicine; Obstetrics – Gynecology


Introduction/Background Hydatidiform mole (HM) is the premalignant form of gestational trophoblastic neoplasia. This entity is of clinical and epidemiological interest because of its potential for significant consequences for women’s reproductive health.

Methodology This is a retrospective study of all cases of molar pregnancy managed in County Emergency Clinical Hospital of Oradea from 1st January 2019 to 30th August 2020. The details of maternal characteristics, clinical presentation, tumor type and management were studied.

Results We diagnosed 17 cases of molar pregnancy during this period of 20 months and wemanaged 5364 deliveries. We also recorded 614 miscarriages and histopathological exams performed. The mean age of the patients with HM was 27,17 years old, with the highest incidence in patients between 15–20 years (29,41%). From allthe cases of HM, 94,12% were diagnosed in first trimester of pregnancy and we had only one case in second trimester pregnancy. Amenorrhea followed by vaginal bleeding was the common symptom in 14 cases (82,3%). A number of 12 patients were admitted because of exaggerated forms of hyperemesis gravidarum. The ultrasound exam showed the size of the uterus larger than the amenorrhea and ovarian lutein cysts were present in almost half of cases. All the patients have had higher then normal values of HCG. In our department all the cases were managed with dilation, suctionand mild curettage when necessary, except one case, finalized with hysterectomy, because of the molar type and the patient’s age. Histopathological exam was performed in all cases. In 11 cases (64,7%) partial hydatidiform mole was diagnosed and in 6 cases complete HM (25,3%). A serial determination of HCG until normal values was always recommended, but we could not do the correct monitoring up to 6–12 months in 7 cases, related to the migration of the population in the region.

Conclusion Molar pregnancy has remained an important cause of maternal morbidity and mortality. There is need for early diagnosis, for proper treatment and follow-up of this condition. Due to the frequent use of ultrasound scanning, the diagnosis of hydatidiform mole could be made early in pregnancy. If hydatidiform mole is suspected, the quantitative estimation of serum level ofHCG should be done. After an appropriate treatment, it is always necessary to follow-up the patient and in present this is a new challenge because the population migration due to new socio-economic conditions and modern life.

Disclosures I have nothing to disclose.

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