Complete Hydatidiform Mole Change in Clinical Profile over Three Decades

OBJECTIVE: To evaluate the change in clinical presentations of complete hydatidiform mole (CHM) in Bangkok, Thailand, over a 30-year period (1978-2007). STUDY DESIGN: Retrospective review of data from Gestational Trophoblastic Disease Registry of Faculty of Medicine Ramathibodi Hospital, Bangkok, was performed. Clinical data of CHM primarily treated at the institute was divided into 3 decades and compared. RESULTS: There were 359 patients with CHM. The incidence decreased from the previously reported rate of 1:413 deliveries to 1:663 deliveries in the last decade. Median age had been constant at around 28 years. Mean gestational age decreased from 16.2 to 12.2 weeks. Vaginal bleeding was still the most common symptom but decreased from 90.6% to 72.8%. Uterine size greater than date decreased from 45.5% to 37.7%. Pregnancy-induced hypertension decreased from 22.0% to 2.5%. Percentage of asymptomatic patients increased from 2.9% to 13.6%. Percentages of patients with postmolar gestational trophoblastic neoplasia (GTN) from the first to the last decades were 25.2, 37.8 and 30.0, respectively. CONCLUSION: Over three decades the incidence of CHM decreased, the diagnoses were made earlier and traditional clinical presentations were less severe. However, serious manifestations were still prevalent. The rate of postmolar GTN did not improve despite earlier diagnosis. (J Reprod Med 2012;57:470-474)