InternationalThereported frequency of hydatidiform molevaries greatly. Some of this variability can beexplained by differences in methodology (eg,singlehospital vs population studies, identificationof cases). The reported frequencies range from 1in 100 pregnancies in Indonesia to 1 in 200pregnancies in Mexico to 1 in 5000 pregnancies inParaguay.10 Thestudy of pathologic material fromfirst- and second-trimester abortions established afreguencyof complete andpartial hydatidiformmoles in Ireland of 1 per 1945 pregnancies and 1per 695pregnancies, respectively16
16 ❖International ❖The reported frequency of hydatidiform mole varies greatly. Some of this variability can be explained by differences in methodology (eg, single hospital vs population studies, identification of cases). The reported frequencies range from 1 in 100 pregnancies in Indonesia to 1 in 200 pregnancies in Mexico to 1 in 5000 pregnancies in Paraguay.10 The study of pathologic material from first- and second-trimester abortions established a frequency of complete and partial hydatidiform moles in Ireland of 1 per 1945 pregnancies and 1 per 695 pregnancies, respectively
Mortality/MorbidityAhydatidiform mole is considered malignant ifmetastases or destructive invasion of themyometrium(ie,invasivemole)occurs,orwhenthe serum hCG levels plateau or rise during theperiod of follow-up and an intervening pregnancyisexcluded.Malignancy is diagnosed in 15-20% of patientswith a complete hydatidiform mole and 2-3% ofpartial moles.12,13 Lung metastases are found in4-5% of patientswith a completehydatidiformmole and rarely in cases of partial hydatidiformmoles.17
17 Mortality/Morbidity ❖A hydatidiform mole is considered malignant if metastases or destructive invasion of the myometrium (ie, invasive mole) occurs, or when the serum hCG levels plateau or rise during the period of follow-up and an intervening pregnancy is excluded. ❖Malignancy is diagnosed in 15-20% of patients with a complete hydatidiform mole and 2-3% of partial moles.12,13 Lung metastases are found in 4-5% of patients with a complete hydatidiform mole and rarely in cases of partial hydatidiform moles
RaceDifferences in the frequency ofhydatidiform moles between ethnic groupshave been reported internationally. In theUnited States, comparison of frequency ofhydatidiformmoles inAfricanAmericansand Caucasians have yielded conflictingresults. If differences exist, whether they areduetogeneticdifferences orenvironmentalfactors is not clear18
18 Race ❖Differences in the frequency of hydatidiform moles between ethnic groups have been reported internationally. In the United States, comparison of frequency of hydatidiform moles in African Americans and Caucasians have yielded conflicting results. If differences exist, whether they are due to genetic differences or environmental factors is not clear
SexHydatidiform moleisadiseaseof pregnancyandtherefore a disease of women.AgeHydatidiform mole is more common at theextremes ofreproductive age.Women in theirearly teenage or perimenopausal years aremost atrisk.Women older than 35 years have a 2-foldincrease in risk. Women older than 40 yearsexperience a 5- to 10-fold increase in riskcompared to younger women.Parity does notaffect the risk19
19 ❖Sex ❖Hydatidiform mole is a disease of pregnancy and therefore a disease of women. Age ❖Hydatidiform mole is more common at the extremes of reproductive age. Women in their early teenage or perimenopausal years are most at risk.Women older than 35 years have a 2-fold increase in risk. Women older than 40 years experience a 5- to 10-fold increase in risk compared to younger women. Parity does not affect the risk