Cagayan Ma Stephanie Fay S
J Reprod Med. 2014 May-Jun;59(5-6):235-40.
To describe the clinicopathologic profile of patients diagnosed with molar pregnancy and complications associated with the disease and their management at a tertiary government hospital.
A descriptive retrospective review of medical records of patients diagnosed with hydatidiform mole for a 5-year period was done. The demographics, clinical course, management options and complications, monitoring and progression to malignancy, and histopathologic diagnosis of these patients were reviewed.
From January 2008-December 2012 there were 551 cases of molar pregnancies. The hospital-based incidence of hydatidiform mole was 13.38/1,000 pregnancies. The most common manifestation was vaginal bleeding, with 98% (540/551) of patients. However, 75% (405/540) had significant anemia described as hemoglobin level < 10 mg/dL, and 32% (173/540) had accompanying pallor, hypotension and tachycardia. Other medical complications included those related to increased beta-hCG titers such as preeclampsia, hyperthyroidism and pulmonary insufficiency. The most common histopathologic diagnosis (71%) was complete hydatidiform mole. Seventy percent of patients were given methotrexate chemoprophylaxis, mainly due to serum hCG > 100,000 mIU/ mL. Of the 551 patients 49 (9%) progressed to malignancy within the next 36 months. The mortality rate was 1.6% (9/551). The most common cause of mortality was hemorrhagic complication.
At the Philippine General Hospital hydatidiform mole is not uncommon. The knowledge of the clinical course of the condition as well as prompt and appropriate management of complications is integral in its management for an excellent prognosis.
描述在一家三级政府医院被诊断为葡萄胎妊娠的患者的临床病理特征、与该疾病相关的并发症及其管理。
对确诊为葡萄胎的患者的病历进行了为期5年的描述性回顾性研究。回顾了这些患者的人口统计学、临床病程、管理选择和并发症、监测及恶变进展情况以及组织病理学诊断。
2008年1月至2012年12月期间有551例葡萄胎妊娠病例。以医院为基础的葡萄胎发病率为每1000例妊娠中有13.38例。最常见的表现是阴道出血，98%（540/551）的患者出现此症状。然而，75%（405/540）的患者有严重贫血，定义为血红蛋白水平<10mg/dL，32%（173/540）的患者伴有面色苍白、低血压和心动过速。其他医学并发症包括与β-hCG水平升高相关的并发症，如先兆子痫、甲状腺功能亢进和肺功能不全。最常见的组织病理学诊断（71%）是完全性葡萄胎。70%的患者接受了甲氨蝶呤化学预防，主要原因是血清hCG>100,000mIU/mL。在551例患者中，49例（9%）在接下来的36个月内进展为恶性肿瘤。死亡率为1.6%（9/551）。最常见的死亡原因是出血性并发症。
在菲律宾总医院，葡萄胎并不罕见。了解该疾病的临床病程以及对并发症进行及时、恰当的管理对于其良好预后的管理至关重要。
