Radiology Lectures | Radquarters

Ultrasound of Complete Molar Pregnancy

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In this radiology lecture, the ultrasound appearance of complete molar pregnancy is revealed.

Key points include:

  • AKA hydatiform mole = Most common form of gestational trophoblastic disease.
  • Gestational trophoblastic neoplasia (GTN) less common = Invasive mole and choriocarcinoma.
  • Approximately 1/1,000 pregnancies is a molar pregnancy.
  • Most common in females under age 20 and over age 35.
  • Two types of molar pregnancy: Complete (most common) and partial.
  • Complete: Diploid (paternal DNA only), no fetus, more likely to be complicated by GTN.
  • Partial: Triploid (maternal and paternal DNA), abnormal fetus or fetal parts, harder to diagnose.
  • Complete hydatiform mole presentation: Vaginal bleeding, enlarged uterus inconsistent with dates, hyperemesis. Markedly elevated β-hCG level (variable for partial molar pregnancies).
  • Large theca lutein cysts due to ovarian stimulation from elevated β-hCG, but uncommon.
  • US: Heterogeneous, echogenic mass (“snowstorm” appearance), small anechoic cystic spaces (“cluster of grapes”) = hydropic chorionic villi.
  • Treatment: Dilation & curettage. β-hCG levels monitored until no longer detectable to confirm no residual disease.

    • To learn more about the Samsung RS85 Prestige ultrasound system, please visit:   https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4

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    Radiology Lectures | RadquartersBy Daniel J. Kowal, MD
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