CCoPE
Date: 2002-02-26

Question:
If a molar pregnancy is suspected by a radiologist performing an Ultrasound and suggests a Beta HCG be done to rule out GTN, would the blood test aid in the diagnosis of a mole? And if it turns out to be a co-exisiting fetus with a complete mole, what should happen next? Would the mother be at greater risk for health complications and an increased chance of needing chemotherapy after attempting to carry to term?

Answer:
The following information should not replace the assessment and advice you have been receiving from your physician (cancer specialist, obstetrician, or any other healthcare provider). It is offered for your information only

If a molar pregnancy is suspected by the ultrasound appearance a beta-hcg needs to be done. If the levels are extremely high it confirms the diagnosis of a molar pregnancy. If the levels are low it is suggestive of a different diagnosis. It is only a blood test and it is helpful in making the diagnosis. If it is a molar pregnancy it becomes a useful marker to the progress of the disease and more so to the effect of therapy.

If there is a live fetus with a molar pregnancy it is called an incomplete mole. It is an unlikely event as most moles are complete moles (without a fetus). The suggested therapy is an evacuation of the uterus (the mole and the fetus). Doing so guarantees a cure in 99%. Future pregnancies have to be deferred for another year but are usually quite uneventful. An incomplete mole has a higher tendency to turn into the malignant form of a mole - a choriocarcinoma. If an incomplete mole is diagnosed it needs to be discussed with a gynecological oncologist in terms of management options. We hope this information is useful.