[New diagnostic approach to different hydatidiform mole types, hydropic abortions and relevant clinical management]. / Nové diagnosticki prístupy k ruzným typum hydatidózních mol, hydropickým abortum a príslusné klinické postupy.

ABSTRACT

OBJECTIVE: To describe new diagnostic approach to complete hydatidiform mole, immature complete hydatidiform mole, partial hydatidiform mole, proliferative mole and hydropic abortion. TYPE OF STUDY Original research. SETTING: Trophoblastic Disease Center in the Czech Republic (TDC-CZ), Institute for the Care of Mother and Child, Prague. METHODS: Our study consists of 1321 partial hydatidiform moles, 805 complete hydatidiform moles, 524 proliferative moles, and over 2500 hydropic abortuses diagnosed and treated at theTDC-CZ, besides which 2896 of these lesions were examined at the TDC-CZ by referral. The material was examined by routine histopathological methods, which in selected cases was supplemented by immunohistological examination and correlated with cytogenetic and molecular genetic results and clinical features. RESULTS: The study describes the diagnostic procedures enabling the differential diagnosis between mature complete hydatidiform mole, immature complete hydatidiform mole, partial hydatidiform mole, proliferative mole and hydropic abortion. Fourteen histological parameters have been defined which are most common, individually or in combination, in various types of hydatidiform moles and hydropic abortions. Warning is given to errors in histological diagnosis correlated with cytogenetic and molecular genetic results. Proposed reliable method of eliminating the influence of these errors on the possible development of trophoblastic disease. CONCLUSION: The study describes differential diagnosis of complete hydatidiform mole, immature complete hydatidiform mole, partial hydatidiform mole, proliferative mole, hydropic abortion and relevant clinical management.