Abstract
Hydatidiform moles (HMs) are abnormal conceptions of excessive trophoblast development
resulting in abnormal human pregnancies with no embryo and cystic degeneration of
the chorionic villi. Prompt diagnosis, treatment and follow-up of patients using assays
for βhCG from centres that specialise in this condition enable early diagnosis of
potential malignant change.
Hydatidiform moles occur quite frequently and although recurrence is rare, women who
have experienced one molar pregnancy should be aware that they are at an increased
risk of a further molar pregnancy in comparison to other women in the general population.
For some women multiple molar pregnancies occur. In these women the recurrent molar
pregnancies may be non-familial, referred to as recurrent molar hydatidiform moles
in this article, or may result from an inherited predisposition, which we refer to
as familial recurrent hydatidiform moles. We use the term familial biparental hydatidiform
moles (FBHMs) for cases in which the parental contribution to the moles has been investigated
and found to be biparental. It is important to recognise, however, that in some apparently
non-familial cases, the absence of female siblings, or the absence of female siblings
who have tried to conceive, may not allow the inherited nature of the molar pregnancies
to manifest in more than one woman and be obviously familial.
This review considers our current understanding about the aetiology of HMs and explores
the mechanisms of both types of recurrent hydatidiform moles. It highlights the role
that genetics can play in determining the origin of multiple molar pregnancies, which
should be considered essential in providing women with accurate advice about their
risk of recurrence, so allowing them to make appropriate reproductive choices.
Keywords
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Article info
Publication history
Published online: February 08, 2010
Accepted:
January 24,
2010
Received in revised form:
December 22,
2009
Received:
July 16,
2009
Identification
Copyright
© 2010 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
