Hydatidiform mole: age‐related clinical presentation and high rate of severe complications in older women. (20th March 2014)

• Record Type: Journal Article
• Authors: Mangili, Giorgia; Giorgione, Veronica; Gentile, Cinzia; Bergamini, Alice; Pella, Francesca; Almirante, Giada; Candiani, Massimo
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 93:Number 5(2014)
• Page Start: 503
• Page End: 507
• Publication Date: 2014-03-20
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12357
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12357-abs-0001"> <title>Abstract</title> <sec id="aogs12357-sec-0001" sec-type="section"> <title>Objective</title> <p>The purpose of this study was to demonstrate differences in clinical presentation of hydatidiform mole between women ≥40 years and younger women.</p> </sec> <sec id="aogs12357-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective study.</p> </sec> <sec id="aogs12357-sec-0003" sec-type="section"> <title>Setting</title> <p>A tertiary referral unit in northern Italy.</p> </sec> <sec id="aogs12357-sec-0004" sec-type="section"> <title>Population</title> <p>Three hundred and sixty‐five women with hydatidiform mole were divided into group A (<40 years, 318 cases) and group B (≥40 years, 47 cases).</p> </sec> <sec id="aogs12357-sec-0005" sec-type="section"> <title>Methods</title> <p>Clinical presentation between groups A and B was analyzed, also considering partial hydatidiform mole and complete hydatidiform mole.</p> </sec> <sec id="aogs12357-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Differences in clinical presentation according to woman's age.</p> </sec> <sec id="aogs12357-sec-0007" sec-type="section"> <title>Results</title> <p>In group B the diagnosis of hydatidiform mole at ≥12 gestational weeks was more frequent (<italic>p</italic> < 0.001) and the detection of ultrasound features was higher (<italic>p</italic> < 0.05) than in group A. Vaginal bleeding (<italic>p</italic> < 0.05), increased uterine volume (<italic>p</italic> < 0.0001) and hyperemesis (<italic>p</italic> < 0.05) occurred more frequently in group B. In the women with complete hydatidiform mole, group B women presented with vaginal bleeding (<italic>p</italic> < 0.001), increased uterine volume (<italic>p</italic> < 0.05) and hyperemesis (<italic>p</italic> < 0.05) more frequently than group A women. Complete hydatidiform mole was more commonly diagnosed after 12 weeks of gestation in group B (<italic>p</italic> < 0.0001). In women ≥50 years, an increased rate of disease‐related complications was detected.</p> </sec> <sec id="aogs12357-sec-0008" sec-type="section"> <title>Conclusions</title> <p>The clinical features of hydatidiform mole in women ≥40 years are different from those seen in younger women. Failures in the early detection of hydatidiform mole in older women may expose them to a higher rate of severe complications.</p> </sec> </abstract>