Department of Obstetrics and Gynecology, Galilee Medical Cente, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
Department of Obstetrics and Gynecology, Galilee Medical Cente, Israel.
Eur J Obstet Gynecol Reprod Biol. 2022 Jul;274:136-141. doi: 10.1016/j.ejogrb.2022.05.026. Epub 2022 May 25.
Molar pregnancy is the most common type of gestational trophoblastic disease. Several recent reports have described changes in the clinical representation, the incidence and the diagnostic sensitivity of molar pregnancy. These changes could be due to widespread use of transvaginal ultrasound and beta-hCG testing in the management of routine first-trimester investigations.
This is a retrospective study of 144 women diagnosed with partial or complete mole at a regional medical center during 2007-2020. Incidence, demographics, clinical features and diagnostic sensitivity were compared between 2007 and 2014 and 2015-2020, and attempts were made to understand the bases of the changes between the time periods.
Sixty-two moles were diagnosed during 2007-2014 and 82 during 2015-2020. The proportions of complete moles in the respective periods were 65% (40) and 18% (15). From the earlier to the later period, the incidence and proportion of complete moles decreased, and of partial moles, increased. The median gestational age at diagnosis of molar pregnancy was 9.3 weeks. In the later period, women presented less frequently with vaginal bleeding, though this remained the most common presenting symptom. The proportion of women who underwent surgical evacuation of the uterus due to suspected molar pregnancy decreased, as did the proportion of moles that was suspected in ultrasound evaluation (P < 0.001).
The proportion of complete moles decreased between the periods examined. Gestational age at diagnosis was similar to data from 1994 to 2013. Some typical presenting symptoms of molar pregnancy decreased. However, earlier diagnosis of missed abortion can miss diagnoses of molar pregnancy.
葡萄胎是最常见的妊娠滋养细胞疾病类型。近期有几篇报道描述了葡萄胎的临床表现、发病率和诊断敏感性的变化。这些变化可能与经阴道超声和β-HCG 检测在常规早孕期检查中的广泛应用有关。
这是对 2007 年至 2020 年期间在一家地区医疗中心诊断为部分或完全性葡萄胎的 144 名女性进行的回顾性研究。比较了 2007 年至 2014 年和 2015 年至 2020 年期间的发病率、人口统计学特征、临床特征和诊断敏感性，并尝试了解两个时间段之间变化的基础。
2007 年至 2014 年期间诊断出 62 例葡萄胎，2015 年至 2020 年期间诊断出 82 例。相应时期完全性葡萄胎的比例分别为 65%（40 例）和 18%（15 例）。与早期相比，晚期完全性葡萄胎的发病率和比例下降，部分性葡萄胎的发病率和比例上升。葡萄胎诊断时的中位孕龄为 9.3 周。在晚期，尽管阴道出血仍然是最常见的首发症状，但就诊时出现阴道出血的女性比例减少。因疑似葡萄胎而行子宫切除术的女性比例减少，超声评估中疑似葡萄胎的比例也减少（P<0.001）。
两个时期的完全性葡萄胎比例下降。诊断时的孕龄与 1994 年至 2013 年的数据相似。一些典型的葡萄胎首发症状减少。然而，对于错过流产的早期诊断可能会错过葡萄胎的诊断。
