[Management of molar pregnancy. Diagnosis of choriocarcinomas and invasive moles].

The management of a molar pregnancy is envisaged on the basis of experience involving the evacuation and surveillance of a mole in 109 cases. A pathological and cytogenetic distinction is drawn between perivillous hyperplasia (102 cases) and embryonic mole or triploid syndrome (7 cases). The diagnosis of choriocarcinoma (20 cases) and of invasive moles (28 cases) is envisaged on the basis of a series including 59 cases of abnormal post-molar or post-partum course. The diagnosis may be approached by pelvic arteriography and the Ishizuka severity scale. A diagnosis is important in the selection of appropriate treatment: clinical surveillance for simple delayed involution, single drug chemotherapy for invasive moles and polychemotherapy after thorough radiological and echotomographic assessment for choriocarcinoma.