Treatment of Molar pregnancy in Chomthong Hospital

Abstract

           Background: Molar pregnancy is one of abnormal pregnancy. Signs, symtomps and  complication depend on gestational age at time of diagnosis. Treatment was termination of pregnancy and patients should be monitored with weekly determination of serum B-hCG level until these were normal for 3 consecutive weeks , follow by monthly determination until the level were normal for 6 consecutive months. Design: A retrospective cohort study of 20 cases with pathological diagnosis of molar pregnancy in Chomthong hospital between October 2001 to  September 2005 Result: Most cases(75%) present with abnormal vaginal bleeding complicated in pregnancy. Gold standard of diagnosis were ultrasonography and serum B-hCG level. Choices of termination of pregnancy were suction curettage (11 cases), dilatation curettage (7 cases) and hysterectomy (2 cases), depend on uterine size, maternal age and fertility requirement. After treatment all of patients were follow up with physical examination and serum B-hCG level weekly until negative then monthly for 6-12 months. 7 cases were diagnosis as persistent mole and refer for chemotheraphy, 6 of 7 were remission with single regimen chemotheraphy only 1 case was metastatic GTD. Most case accept treatment and follow up program. 5 cases were pregnant after remission from disease, all babies were healthy.