Simplifying the preevacuation testing strategy for patients with molar pregnancy.
OBJECTIVE
To review our institution's preevacuation testing strategy for suspected molar pregnancy to determine whether a simplified approach might be indicated.


METHODS
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.


CONCLUSIONS
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.
Knowles
Lynne M
LM
Southwestern Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, J7.124, Dallas, TX 75390-9032, USA.
Drake
Richard D
RD
Ashfaq
Raheela
R
Castrillon
Diego H
DH
Miller
David S
DS
Schorge
John O
JO
D000017:ABO Blood-Group System; D000022:Abortion, Spontaneous / Q000097:blood; D000293:Adolescent; D000328:Adult; D001772:Blood Cell Count; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood / Q000652:urine; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis* / Q000601:surgery; D008111:Liver Function Tests; D008499:Medical Records; D008963:Molar; D011247:Pregnancy; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014619:Vacuum Curettage / Q000379:methods
D000017:ABO Blood-Group System; D018997:Chorionic Gonadotropin, beta Subunit, Human