Complete Hydatidiform Mole

Molar pregnancies have a biphasic age distribution, with increased incidence at the reproductive extremes: before age 20 and after age 40.

Increased incidence has also been noted in women of Asian descent.

Other risk factors include low socioeconomic status, prior molar pregnancies, and nulliparity.

In classic complete hydatidiform mole (CHM) patients present with vaginal bleeding, vomiting, thyrotoxicosis, and markedly elevated levels of beta-human chorionic gonadotropin (HCG).

Ultrasonographic evaluation shows a “snowstorm” or “Swiss cheese” appearance, which corresponds to the swollen, hydropic villi (hydatidiform, meaning grapelike).

Early CHMs typically do not exhibit the classic signs and may be detected clinically as a missed abortion.

In early CHM, beta-HCG levels are only mildly elevated.

The diagnosis of an early CHM may not be apparent until histologic examination of the products of conception.