Abstract
BackgroundEarly detecting hydatidiform mole in missed abortion is challenge. In this retrospective observational study, we analysed the sensitivity of detecting hydatidiform mole by pre-evacuation ultrasound examination or naked eye after surgical uterine evacuation in missed abortion.MethodsData on 577 cases with histologically confirmed hydatidiform mole were collected over a 10-year period and analysed. Data included serum β-hCG level before surgical evacuation, the ultrasound examination findings, histology findings and naked eye findings. In addition, serum β-hCG level on 2398 cases without hydatidiform mole was also collected.ResultsThe median maternal age was 29 (range, 17–53) years and the range of gestational age was 6 to 12 weeks. The sensitivity of detecting hydatidiform mole by ultrasound examination or by naked eye was 25% or 60% respectively. This sensitivity was not increased by the combination of ultrasound and naked eye. There was no difference in the sensitivity of detecting subtypes of hydatidiform mole. The higher β-hCG level was seen in cases with hydatidiform mole, compared to cases without hydatidiform mole. However, there was a lot of overlap in the distributions of β-hCG between the two groups.ConclusionsIn this study, we found lower sensitivity of detecting hydatidiform mole by ultrasound in missed abortion. β-hCG level was higher in hydatidiform mole than in non- hydatidiform mole in missed abortion. Although higher sensitivity of detecting hydatidiform mole is seen by naked eye (60%), in order to minimise missed opportunity of detecting hydatidiform mole, our study suggests that routine histopathological examination is necessary in missed abortion.
Highlights
Detecting hydatidiform mole in missed abortion is challenge
Data on serum levels of β-human chorionic gonadotropin at the time of attending to our unit, preevacuation ultrasound examination, histology findings and naked eye findings after surgical uterine evacuation were only available on 577 cases with hydatidiform mole
We analysed the sensitivity of detecting hydatidiform mole by pre-evacuation ultrasound examination or by naked eye in these 577 cases
Summary
Detecting hydatidiform mole in missed abortion is challenge. In this retrospective observational study, we analysed the sensitivity of detecting hydatidiform mole by pre-evacuation ultrasound examination or naked eye after surgical uterine evacuation in missed abortion. With the increasing performance of ultrasound examination either routinely in the first trimester of pregnancy or for management of early pregnancy complications [7], hydatidiform mole may be able to be detected before developing into invasive moles or choriocarcinoma. Studies suggested that around 40 to 56% of hydatidiform mole were able to be detected on pre-evacuation ultrasound examination in miscarriages in the United Kingdom [8,9,10,11]. This detection rate may vary depending on the individual clinician’s experience and equipment among the countries [9, 12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
