Utility of manual vacuum aspiration followed by curettage in the treating hydatidiform mole: A retrospective analysis

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY Journal of Obstetrics and Gynaecology Research Pub Date : 2025-01-08 DOI:10.1111/jog.16210

Ui Aoki, Kosuke Yoshida, Yuko Yasui, Yuki Nishiko, Akira Yokoi, Nobuhisa Yoshikawa, Kimihiro Nishino, Eiko Yamamoto, Kaoru Niimi, Hiroaki Kajiyama

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Abstract

Aim

While manual vacuum aspiration (MVA) is commonly employed for early first-trimester abortions, its effectiveness in treating hydatidiform mole is still unclear. This study sought to evaluate the efficacy and safety of MVA in comparison to dilation and curettage (D&C) for managing hydatidiform mole.

Methods

We conducted a retrospective review of medical records for 198 patients with hydatidiform mole treated at Nagoya University Hospital between 2004 and 2023. After excluding cases with incomplete data, we compared 106 patients who underwent D&C with 60 patients treated with MVA followed by curettage. We evaluated the surgical duration, intraoperative blood loss, and the occurrence of post-molar gestational trophoblastic neoplasia (GTN) in both groups.

Results

The surgical duration and blood loss were similar between the MVA and D&C groups. The average surgical time was 13.2 min for D&C and 11.8 min for MVA (p = 0.145). Most cases in both groups experienced blood loss of less than 10 mL, with no significant difference (p = 0.066). Over a median follow-up period of 33.4 months, 25 cases developed post-molar GTN. All GTN cases originated from complete hydatidiform mole (25 of 132 cases, 18.9%), and none were from partial hydatidiform mole. Kaplan–Meier analysis, focusing only on patients with complete hydatidiform mole, indicated no significant difference in the time to onset of GTN between the D&C and MVA groups (p = 0.632).

Conclusions

MVA followed by curettage is a viable approach for treating molar pregnancy.

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人工真空抽吸后刮除治疗葡萄胎的回顾性分析。

目的：虽然人工真空抽吸（MVA）通常用于早期妊娠流产，但其治疗葡萄胎的有效性尚不清楚。本研究旨在评估MVA与扩张和刮除（D&C）治疗葡萄胎的有效性和安全性。方法：回顾性分析2004年至2023年在名古屋大学医院治疗的198例葡萄胎患者的病历。在排除数据不完整的病例后，我们比较了106例接受D&C的患者和60例接受MVA后刮除的患者。我们评估了两组的手术时间、术中出血量和磨牙后妊娠滋养细胞瘤（GTN）的发生情况。结果：MVA组和D&C组的手术时间和出血量相似。D&C平均手术时间为13.2 min， MVA平均手术时间为11.8 min （p = 0.145）。两组患者出血量均小于10 mL，差异无统计学意义（p = 0.066）。在中位33.4个月的随访期间，25例发生磨牙后GTN。所有GTN病例均来自完全葡萄胎（25例，18.9%），部分葡萄胎无一例。Kaplan-Meier分析仅针对完全葡萄胎患者，D&C组与MVA组在GTN发病时间上无显著差异（p = 0.632）。结论：MVA +刮除是治疗磨牙妊娠的可行方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.