A clinico-pathological study of complete and partial hydatidiform moles in a Nigerian population

Abstract

In a review of 208 cases of hydatidiform moles (HM) managed at the University College Hospital Ibadan, Nigeria between January 1966 and December 1996, there were 105 cases of complete hydatidiform mole (CHM) and 103 cases of partial hydatidiform mole (PHM). The ratio of PHM to CHM was 1:1. The institutional frequency for PHM is one per 667 deliveries, while that of CHM is one per 655 deliveries. In contrast to CHM, the presentation of PHM was less dramatic. The mean age for both types of HM was 28 years, although there was a slightly increased difference in the population of younger patients aged (21-30 years) for PHM (56·3%) as against CHM (40%), respectively. The pre-evacuation uterine size was larger than dates in CHM (40%) compared to PHM (8%), although the mean gestational age was higher in PHM (19·8 weeks) when compared to CHM (15·2 weeks). Sixty-five patients with CHM (61·9%) presented with heavy irregular vaginal bleeding before evacuation compared to five patients (4·9%) with PHM. Gestational trophoblastic tumour (GTT) occurred in 20 patients with CHM (19·0%) compared to two patients (2·1%) with PHM. We conclude that the incidence of PHM is higher in our environment than hitherto reported and consequently there is need for greater awareness among health-care providers of the clinicopathological features of this enigmatic but interesting disease entity and development of facilities for routine cytogenetics. It is advisable that the follow-up period in patients with PHM should not be more than a year, because of the rarity of post-evacuation sequelae.