Institutional members access full text with Ovid®

Gestational Trophoblastic Disease

GARNER, ELIZABETH I. O. MD, MPH; GOLDSTEIN, DONALD P. MD; FELTMATE, COLLEEN M. MD; BERKOWITZ, ROSS S. MD

Clinical Obstetrics & Gynecology: March 2007 - Volume 50 - Issue 1 - pp 112-122
doi: 10.1097/GRF.0b013e31802f17fc
First Trimester Pregnancy Complications

Hydatidiform mole, a disorder of fertilization, comprises complete and partial molar pregnancy. The pathologic and clinical features of complete and partial mole are well-described. Because of earlier diagnosis, however, the clinical presentation of complete molar pregnancy has significantly changed in recent years. The earlier diagnosis of complete mole is associated with more subtle pathologic findings than later molar pregnancy. The use of immunohistochemical techniques for the detection of maternally imprinted genes as ancillary testing in the diagnosis of complete and partial mole is therefore increasing. Although most molar pregnancies are sporadic, a familial syndrome of recurrent hydatidiform mole has been described. Further research will hopefully lead to identification of the gene defect responsible for this uncommon syndrome. Fortunately, patients with molar pregnancies can generally anticipate normal future reproduction. Close hCG follow-up after molar pregnancy is required to rule out development of postmolar gestational trophoblastic neoplasia. Recent studies suggest that a shorter period of postmolar follow-up may be reasonable for patients with both complete and partial molar pregnancy.

Brigham and Women's Hospital, New England Trophoblastic Disease Center, Donald P. Goldstein, M.D. Trophoblastic Tumor Registry, Dana Farber Cancer Institute, Gillette Center for Women's Cancers, Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts

Correspondence: Elizabeth I. O. Garner, MD, MPH, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. E-mail: egarner@partners.org

© 2007 Lippincott Williams & Wilkins, Inc.