Simplifying the preevacuation testing strategy for patients with molar pregnancy

Lynne M. Knowles, Richard D. Drake, Raheela Ashfaq, Diego H. Castrillon, David S. Miller, John O. Schorge

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To review our institution's preevacuation testing strategy for suspected molar pregnancy to determine whether a simplified approach might be indicated. STUDY DESIGN: Patients diagnosed with molar pregnancy from 1999 to 2004 were identified. Clinical data were retrospectively extracted from medical records. RESULTS: One hundred fifty-eight women diagnosed (mean age, 24 years) underwent dilatation and curettage. Molar pregnancy was suspected at presentation in 111 (70%); 47 (30%) cases were presumed miscarriages, and the diagnosis was confirmed only after histologic evaluation of the specimen. Initial testing included complete blood count (CBC) (87%), liver function tests (LFT) (63%), thyroid-stimulating hormone (TSH) level (72%), clotting function studies (26%) and chest radiograph (84%). One patient with right upper quadrant pain had elevated LFTs and a coagulopathy that resolved after evacuation. One woman with a palpably enlarged goiter and elevated TSH level was diagnosed with thyroid carcinoma. No chest radiograph demonstrated metastatic disease. CONCLUSION: We advocate a simplified approach to preevacuation testing for suspected molar pregnancy that includes a CBC and blood type with antibody screen. Clinical assessment should prompt additional evaluation in the rare patient with suspicious signs and symptoms.

Original languageEnglish (US)
Pages (from-to)685-688
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume52
Issue number8
StatePublished - Aug 1 2007

Keywords

  • Gestational trophoblastic neoplasms
  • Gonadotropins
  • Hydatidiform mole

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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