Which physical findings are characteristic of complete hydatidiform mole?

Updated: Feb 16, 2018
  • Author: Lisa E Moore, MD, FACOG; Chief Editor: Warner K Huh, MD  more...
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Answer

Note the following:

  • Size inconsistent with gestational age: A uterine enlargement greater than expected for gestational age is a classic sign of a complete mole. Unexpected enlargement is caused by excessive trophoblastic growth and retained blood. However, patients also present with size appropriate or smaller than expected for the gestational age.

  • Preeclampsia: Pelvic ultrasonography has resulted in the early diagnosis of most cases of hydatidiform mole and preeclampsia is seen in less than 2% of cases. [30]

  • Theca lutein cysts: These are ovarian cysts greater than 6 cm in diameter and accompanying ovarian enlargement. These cysts are not usually palpated on bimanual examination but are identified by ultrasonography. Patients may report pressure or pelvic pain. Because of the increased ovarian size, torsion is a risk. These cysts develop in response to high levels of beta-hCG. They are reported in 11% of cases diagnosed at  longer than10-weeks' gestational age. The cysts spontaneously regress after the mole is evacuated, but it may take up to 12 weeks for complete regression.

    Theca lutein cysts. Theca lutein cysts.
    Complete mole. Complete mole.
    Complete mole with an area of clot near cervix con Complete mole with an area of clot near cervix consistent with bleeding.

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