What is the role of lab studies in the evaluation of suspected hydatidiform mole?

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

The following laboratory studies may be used to evaluate patients with suspected hydatidiform mole:

  • Quantitative beta-hCG levels: hCG levels greater than 100,000 mIU/mL indicate exuberant trophoblastic growth and raise suspicion for a molar pregnancy. However, a molar pregnancy may have a normal hCG level.
  • Complete blood cell count with platelets: Anemia could be present and coagulopathy could occur.
  • Clotting function studies: Test clotting function to exclude the development of a coagulopathy or to treat one if discovered.
  • Liver function tests
  • Blood urea nitrogen (BUN) and serum creatinine levels
  • Blood type and Rh factor
  • Thyroxine level: Although women with molar pregnancies are usually clinically euthyroid, biochemical hyperthyroidism has been reported in 6% of patients with hydatidiform mole diagnosed at 5-9 weeks of gestation and in 28% when the diagnosis is made after 10 weeks' gestation. Patient may present with signs and symptoms of hyperthyroidism. Clinical hyperthyroidism occurs in less than 3% of cases.
  • Serum inhibin A and activin A levels: Serum inhibin A and activin A have been shown to be 7- to 10-fold higher in molar pregnancies than normal pregnancies at the same gestational age. The fall in inhibin A and activin A after evacuation may prove helpful. [37] However, of the readily available markers, serum hCG levels is the standard of care.

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