Braga Antônio, Chagas Marcela, Asrani Manisha, Soares Juliana Pereira, Sun Sue Yazaki, Araujo Júnior Edward, Mattar Rosiane, Amim Junior Joffre, Rezende-Filho Jorge, Horowitz Neil S, Berkowitz Ross S
Department of Gynecology and Obstetrics, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 22240-003, RJ, Brazil.
Department of Maternal and Child Health, School of Medicine, Fluminense Federal University, Niterói 24070-090, RJ, Brazil.
Diagnostics (Basel). 2025 Aug 18;15(16):2068. doi: 10.3390/diagnostics15162068.
Hydatidiform mole is a trophoblastic disorder resulting from abnormal fertilization. Diagnosis is established through a combination of clinical findings, elevated serum human chorionic gonadotropin (hCG) levels, and characteristic features on transvaginal ultrasound. Timely and accurate diagnosis is essential for initiating prompt treatment and preventing medical complications. Uterine evacuation, preferably via vacuum aspiration, is the treatment of choice due to its high efficacy and safety profile. Adjunctive techniques, such as hysteroscopy and intraoperative ultrasonography, enhance the safety and effectiveness of uterine evacuation and should be available to patients, especially at specialized referral centers equipped to manage this diagnosis. In selected cases, particularly in women with fulfilled reproductive goals or those at a high risk of developing post-molar gestational trophoblastic neoplasia (GTN), total abdominal hysterectomy is appropriate. Postoperative follow-up with serial measurements of hCG is essential for monitoring remission and for the early detection of post-molar GTN, which develops in approximately 20% of cases of complete molar pregnancies and 1-4% of partial molar pregnancies. This article provides a comprehensive review of the diagnosis of hydatidiform mole and the surgical techniques employed in the treatment of this condition, emphasizing individualized care and the use of appropriate surgical strategies to treat complications associated with this trophoblastic disease.
葡萄胎是一种由异常受精引起的滋养层疾病。通过结合临床症状、血清人绒毛膜促性腺激素（hCG）水平升高以及经阴道超声的特征性表现来确诊。及时准确的诊断对于启动及时治疗和预防医疗并发症至关重要。子宫排空，最好通过真空吸引，因其高效和安全的特点是首选的治疗方法。辅助技术，如宫腔镜检查和术中超声检查，可提高子宫排空的安全性和有效性，并且应为患者提供，特别是在具备处理该诊断能力的专业转诊中心。在某些特定情况下，特别是对于已实现生育目标的女性或发生葡萄胎后妊娠滋养细胞肿瘤（GTN）风险较高的女性，全腹子宫切除术是合适的。术后连续测量hCG进行随访对于监测缓解情况以及早期发现葡萄胎后GTN至关重要，GTN在大约20%的完全性葡萄胎妊娠病例和1 - 4%的部分性葡萄胎妊娠病例中发生。本文全面综述了葡萄胎的诊断以及治疗该疾病所采用的手术技术，强调个体化护理以及使用适当的手术策略来治疗与这种滋养层疾病相关的并发症。
