A CLINICAL, HISTOPATHOLOGICAL AND FLOW CYTOMETRIC STUDY OF 149 COMPLETE MOLES, 146 PARTIAL MOLES AND 107 NON-MOLAR HYDROPIC ABORTIONS

We have compared the clinical and histological features of 149 complet e moles with 146 triploid partial moles and 107 diploid non-molar hydr opic abortions initially registered as moles for human chorionic gonad otrophin (hCG) follow-up, Forty-one patients with complete moles, five with partial moles and one with hydropic abortion received chemothera py for hCG elevations interpreted as persistent trophoblastic disease. Complete moles were aborted or were evacuated significantly earlier t han partial moles (means of 12.1 and 15.4 weeks; P < 0.001) and hydrop ic abortions significantly earlier than complete moles (mean 10.7 week s; P < 0.005). The means of the highest recorded hCG were higher in co mplete moles (184056 i.v.) than in partial moles (66259 i.v.) and hydr opic abortion (7942 i.v.). When hCG became normal without chemotherapy , this occurred earlier in patients with hydropic abortion than in tho se with partial moles (means of 46.7 days and 62.8 days; P < 0.001) an d earlier in partial moles than in complete moles (mean 78.3 days; P < 0.005). The incidence of partial moles was comparable throughout fert ile years but rose to 1.9 times the average after 40 years. Complete m oles were commoner between 14 and 25 years and after 35 years, reachin g 4.8 times the average after 40 years. Hydropic abortions were rare b efore 25 years and increased with age to 12 times the average after 40 years. Stromal karyorrhexis and shape of villi, before they become hy dropic, discriminate well between complete and partial mole. Hydrops i ncreased and vascularity decreased with molar age and the presence of non-hydropic villi or vessels did not discriminate between partial mol e and the younger complete moles evacuated nowadays.