OBJECTIVE: to determine whether the clinical presentation of hydatidiform mole has changed in the recent years (1992-1998) when compared with historic controls (1960-1981). METHODS: medical records of 80 patients with hydatidiform mole attended in the 1960-1981 period (Group I) were reviewed and compared to data from 801 patients followed in the 1992-1998 period (Group II). The clinical signals and symptoms analyzed were: age distribution, number of pregnancies, vaginal bleeding, hyperemesis, edema, hypertension, large uterus for gestation date and theca lutein cysts of the ovaries. Statistical analyses employed chi-square tests and odds ratio (OR) estimate with the confidence interval (CI) of 95%. RESULTS: concerning age, the disease occurred more frequently in group II than in group I, in patients under 15 and over 40 years old. As to the number of pregnancies, there was no statistical difference only in those patients who were in their third or fourth pregnancies. Arterial hypertension was the only symptom that occurred with similar frequency in both groups. Enlarged uterus was more frequent in group II (41.4 X 31.2% - p <0.05; OR: 1.5; IC: 1.0-2.3). Bleeding remained the most common symptom, occurring in 76.9% of patients (Group II), although it has occurred in 98.7% of the historic controls (p<0.05; OR: 0.04; IC: 0.03 0.04). The following symptoms were also less frequent in group II as compared to group I: hyperemesis (36.5% X 45% - p<0.05; OR: 0.7; IC: 0.4 0.9), edema (12.7% X 20% - p<0.05, OR: 0.5, IC: 0.3 0.8), enlarged uterus for gestational age (41.4% x 31.2% - p<0.05; OR: 1.5; IC: 1.0 2.3) and theca lutein cysts (16.4% X 41.2% - p<0.05; OR: 0.3; IC: 0.2 0.4). Ultrasound has become the commonest method of diagnosis (89.2% - p<0.05), allowing early detection of hydatidiform moles. CONCLUSION: there was a decrease of the traditional symptoms in current patients with hydatidiform mole as compared to historic controls, due to early diagnosis through ultrasonography.
Gestational trophoblastic disease; Clinical presentation; Ultrasound
