RCOG World Congress 2025

Detection rate of Molar Pregnancy on Ultrasound and Challenges in Management

Background:

Molar Pregnancy is an abnormal pregnancy which if detected earlier has a good prognosis .

Complete Mole : 2 sets of paternal genes-No Fetus

Partial Mole: 3 sets of genes (one maternal and 2 paternal)-Non-Viable Fetus.

Aims of Audit :

1. To find detection rate of Molar Pregnancy on ultrasound scan.

2. Association with Ethnicity and Age.

3. Management Challenges and good practice

Materials and Methods:

•Retrospective data collection from Histological diagnosis of Molar Pregnancy.

•Pictures gathered from PACS

•26 patients collected over 6 months period.

•Hospital systems used for rest of information.

Results

•Age: 42% of patients were above 35 years of age.

•BMI : No association with high BMI found.

•Clinical Presentation: 46% presented as bleeding PV.

•Gestational Age at Presentation: 60% presented with in 8 weeks of gestation

•Referral Proforma to specialist centre was done in 100% of cases with Contraception advise.

•One Patient got pregnant in follow-up.

Conclusion:

•Detection rate of Complete Molar Pregnancies in line with National average though in Partial Molar Pregnancies it is lower.

•Partial Molar Pregnancy is more common.

•Complete Molar Pregnancies are more likely to bleed at EVAC .

Previous Molar Pregnancies are at risk of Molar pregnancy in future

Recommendations

1.If discrepancy in size of Gestational sac or CRL – repeat scan in 1-2 weeks.

2.SEVAC under USG +senior involvement as likely to bleed.

Proportion of women with histological diagnosis of Molar pregnancy detected on USG .