Hydatidiform mole and medical management of miscarriage

doi:10.1136/bmj.332.7555.1454

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Neil J Sebire, consultant in trophoblastic disease pathology (sebirn@gosh.nhs.uk)

Trophoblastic Disease Unit, Charing Cross Hospital, London WC1N 3JH

EDITOR—Trinder et al suggest that expectant management may be particularly appropriate for cases of incomplete miscarriage and as an alternative management in early fetal death.1 One possible cause of first trimester miscarriage is hydatidiform molar pregnancy, which is associated with a significantly increased risk of subsequent development of persistent gestational trophoblastic disease.

Only around 40% of hydatidiform moles are …