International Journal of Clinical Obstetrics and Gynaecology

Background: Hydatidiform mole (HM) is a benign form of gestational trophoblastic disease (GTD) caused by abnormal trophoblastic proliferation. Early diagnosis and appropriate ?-hCG surveillance are essential to prevent complications and progression to gestational trophoblastic neoplasia.
Objectives: To determine the incidence, clinical presentation, risk factors, management, and outcomes of molar pregnancies at a tertiary care centre (Gandhi Medical College, Hyderabad).
Methods: A retrospective observational study was conducted from 1 April 2017 to 30 September 2018. All women diagnosed with molar pregnancy by ultrasound were included. Clinical data, laboratory findings, management approach, and follow-up outcomes were analyzed.
Results: Among 14,760 deliveries, 34 cases of molar pregnancy were identified (incidence: 2.3 per 1,000 deliveries). The distribution included complete mole (76%), partial mole (21%), and invasive mole (3%). Most women belonged to a low socioeconomic group (89%) and were multigravida (68%). The most common symptoms were amenorrhea (97%), vaginal bleeding (91%), and abdominal pain (67%). Theca lutein cysts occurred in 21%, while preeclampsia and hyperemesis were seen in 12% and 14%, respectively. Suction evacuation was the primary management for all cases except one requiring hysterectomy. One patient with persistent ?-hCG levels was diagnosed with invasive mole and treated successfully with hysterectomy and methotrexate. Most patients normalized ?-hCG levels within 7-9 weeks post-evacuation.
Conclusion: Complete moles were the most common form of molar pregnancy. Early detection through ultrasound and ?-hCG monitoring resulted in reduced morbidity and effective management. Single-agent chemotherapy was adequate for the invasive mole case. Regular long-term ?-hCG follow-up remains essential to prevent malignant progression.