10.5281/zenodo.18155431

Background: Gestational trophoblastic disease comprises a spectrum of disorders arising from abnormal trophoblastic proliferation, of which hydatidiform mole is the most common entity. Although advances in early ultrasonography and β-hCG assays have improved diagnosis and outcomes, molar pregnancy poses significant clinical challenges due to its variable presentation and potential progression to malignant GTD. Periodic evaluation of institutional data is essential to understand regional epidemiology, clinical patterns, management practices and outcomes.

Aims: To determine the proportion of molar pregnancies among hospital admissions, study the clinical spectrum, review treatment modalities and evaluate outcomes of patients with molar pregnancy.

Methodology: This descriptive study with retrospective and prospective components included all diagnosed cases of molar pregnancy admitted to Goa Medical College between January 2016 and May 2021. Cases of invasive mole and placental site trophoblastic tumor were excluded. Clinical, laboratory and ultrasonographic data were collected. Primarily suction-evacuation followed by serial β-hCG monitoring done. Data analyzed using descriptive and inferential statistics.

Results: Among 25,268 pregnant admissions, 42 cases of molar pregnancy were analyzed, yielding an incidence of 1.66 per 1,000 pregnancies. Partial moles constituted 52.4% and complete moles 47.6%. The mean age was 25.78 ± 6.1 years. Vaginal bleeding (66.6%), amenorrhea (97.6%) were the most common presenting features, while 30.9% were asymptomatic. Suction-evacuation was performed in 98% cases with significant decline in β-hCG levels post-evacuation (p<0.0001), with normalization occurring over a mean duration of 9.1 ± 1.3 weeks. All patients achieved complete remission.

Conclusion: Early diagnosis, prompt evacuation and meticulous β-hCG surveillance ensure excellent outcomes.