title: Hydatidiform mole: age-related clinical presentation and high rate of severe complications in older women.
abstract: OBJECTIVE
  The purpose of this study was to demonstrate differences in clinical presentation of hydatidiform mole between women ≥40 years and younger women.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A tertiary referral unit in northern Italy.
  
  
  METHODS
  Three hundred and sixty-five women with hydatidiform mole were divided into group A (<40 years, 318 cases) and group B (≥40 years, 47 cases).
  
  
  METHODS
  Clinical presentation between groups A and B was analyzed, also considering partial hydatidiform mole and complete hydatidiform mole.
  
  
  METHODS
  Differences in clinical presentation according to woman's age.
  
  
  RESULTS
  In group B the diagnosis of hydatidiform mole at ≥12 gestational weeks was more frequent (p < 0.001) and the detection of ultrasound features was higher (p < 0.05) than in group A. Vaginal bleeding (p < 0.05), increased uterine volume (p < 0.0001) and hyperemesis (p < 0.05) occurred more frequently in group B. In the women with complete hydatidiform mole, group B women presented with vaginal bleeding (p < 0.001), increased uterine volume (p < 0.05) and hyperemesis (p < 0.05) more frequently than group A women. Complete hydatidiform mole was more commonly diagnosed after 12 weeks of gestation in group B (p < 0.0001). In women ≥50 years, an increased rate of disease-related complications was detected.
  
  
  CONCLUSIONS
  The clinical features of hydatidiform mole in women ≥40 years are different from those seen in younger women. Failures in the early detection of hydatidiform mole in older women may expose them to a higher rate of severe complications.
authors.affiliation: Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Mangili
authors.forename: Veronica
authors.initials: V
authors.lastname: Giorgione
authors.forename: Cinzia
authors.initials: C
authors.lastname: Gentile
authors.forename: Alice
authors.initials: A
authors.lastname: Bergamini
authors.forename: Francesca
authors.initials: F
authors.lastname: Pella
authors.forename: Giada
authors.initials: G
authors.lastname: Almirante
authors.forename: Massimo
authors.initials: M
authors.lastname: Candiani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D005865:Gestational Age; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006939:Hyperemesis Gravidarum / Q000209:etiology; D008875:Middle Aged; D009929:Organ Size; D011247:Pregnancy; D012189:Retrospective Studies; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014599:Uterus / Q000473:pathology*; D055815:Young Adult
keywords: Hydatidiform mole; clinical presentation; complete hydatidiform mole; disease-related complications; partial hydatidiform mole; patients' age; symptoms