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  • Title: Hydatidiform mole: age-related clinical presentation and high rate of severe complications in older women.
    Author: Mangili G, Giorgione V, Gentile C, Bergamini A, Pella F, Almirante G, Candiani M.
    Journal: Acta Obstet Gynecol Scand; 2014 May; 93(5):503-7. PubMed ID: 24575838.
    Abstract:
    OBJECTIVE: The purpose of this study was to demonstrate differences in clinical presentation of hydatidiform mole between women ≥40 years and younger women. DESIGN: Retrospective study. SETTING: A tertiary referral unit in northern Italy. POPULATION: 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). METHODS: Clinical presentation between groups A and B was analyzed, also considering partial hydatidiform mole and complete hydatidiform mole. MAIN OUTCOME MEASURES: Differences in clinical presentation according to woman's age. RESULTS: In group B the diagnosis of hydatidiform mole at ≥12 gestational weeks was more frequent (p < 0.001) and the detection of ultrasound features was higher (p < 0.05) than in group A. Vaginal bleeding (p < 0.05), increased uterine volume (p < 0.0001) and hyperemesis (p < 0.05) occurred more frequently in group B. In the women with complete hydatidiform mole, group B women presented with vaginal bleeding (p < 0.001), increased uterine volume (p < 0.05) and hyperemesis (p < 0.05) more frequently than group A women. Complete hydatidiform mole was more commonly diagnosed after 12 weeks of gestation in group B (p < 0.0001). In women ≥50 years, an increased rate of disease-related complications was detected. CONCLUSIONS: 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.
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