Hydatidiform mole and its complications: review of patient profiles and management at the university of the Philippines-Philippine General Hospital.

OBJECTIVE

To describe the clinicopathologic profile of patients diagnosed with molar pregnancy and complications associated with the disease and their management at a tertiary government hospital.

STUDY

DESIGN

A descriptive retrospective review of medical records of patients diagnosed with hydatidiform mole for a 5-year period was done. The demographics, clinical course, management options and complications, monitoring and progression to malignancy, and histopathologic diagnosis of these patients were reviewed.

RESULTS

From January 2008-December 2012 there were 551 cases of molar pregnancies. The hospital-based incidence of hydatidiform mole was 13.38/1,000 pregnancies. The most common manifestation was vaginal bleeding, with 98% (540/551) of patients. However, 75% (405/540) had significant anemia described as hemoglobin level < 10 mg/dL, and 32% (173/540) had accompanying pallor, hypotension and tachycardia. Other medical complications included those related to increased beta-hCG titers such as preeclampsia, hyperthyroidism and pulmonary insufficiency. The most common histopathologic diagnosis (71%) was complete hydatidiform mole. Seventy percent of patients were given methotrexate chemoprophylaxis, mainly due to serum hCG > 100,000 mIU/ mL. Of the 551 patients 49 (9%) progressed to malignancy within the next 36 months. The mortality rate was 1.6% (9/551). The most common cause of mortality was hemorrhagic complication.

CONCLUSION

At the Philippine General Hospital hydatidiform mole is not uncommon. The knowledge of the clinical course of the condition as well as prompt and appropriate management of complications is integral in its management for an excellent prognosis.