Molar Pregnancy: Epidemiology, Diagnosis, Management, Surveillance

AbstractPurpose of ReviewThis review describes recommendations for the diagnosis and management of molar pregnancy, with focus on emerging evidence in recent years, particularly as it pertains to nuances of diagnosis, risk stratification, and surveillance of post-molar malignant trophoblastic disease.Recent FindingsTopics discussed include advances in histopathologic diagnosis of molar pregnancy to standardize analysis, most recent estimations of post-molar pregnancy malignancy, and updated surveillance guidelines.SummaryHydatidiform molar pregnancy, resulting from an abnormal fertilization event, is the proliferation of abnormal pregnancy tissue with malignant potential. With increased availability of first trimester ultrasound, early detection of molar pregnancy has increased. While challenging to diagnose radiologically and histologically at early stages, standardization of tissue analysis allows improved detection and increased accuracy of incidence estimate for both complete and partial molar pregnancy. Treatment of molar pregnancy requires evacuation of tissue.  Prophylactic chemotherapy or repeat curettage have been explored but not favored. As new molecular markers are sought, our ability to predict malignant transformation following molar pregnancies will allow for more streamlined surveillance. Recent data support a reduction in the length of surveill ance following normalization of human chorionic gonadotropin levels after evacuation.

Source: Current Obstetrics and Gynecology Reports - February 19, 2022 Category: OBGYN Source Type: research