Molar pregnancy (MP) is a gestational disorder resulting from abnormal fertilization, leading to atypical trophoblastic proliferation and the formation of a complete or partial hydatidiform mole. This condition represents the most common form of gestational trophoblastic disease (GTD) and carries a significant risk of progression to gestational trophoblastic neoplasia (GTN). Although rare in high-income countries, MP remains up to ten times more prevalent in low-income and developing countries, contributing to preventable maternal morbidity and mortality. This narrative review provides an updated, practical overview of the clinical presentation, diagnosis, treatment, and follow-up of MP. A key focus is the challenge of early diagnosis, particularly given the increasing frequency of first-trimester detection, where classical histopathological criteria may be subtle, leading to diagnostic errors. The review innovates by integrating advanced diagnostic methods—combining histopathology, immunohistochemistry using p57Kip2, Ki-67, and p53 markers, along with cytogenetic analysis—to improve diagnostic accuracy in early gestation. The central role of referral centers is also emphasized, not only in facilitating timely treatment and access to chemotherapy, but also in implementing standardized post-molar follow-up protocols that reduce progression to GTN and maternal mortality. By focusing on both advanced diagnostic strategies and the organization of care through referral centers, this review offers a comprehensive, practice-oriented perspective to optimize patient outcomes in GTD and address persistent care gaps in high-burden regions.

Hydatidiform mole is a trophoblastic disorder resulting from abnormal fertilization. Diagnosis is established through a combination of clinical findings, elevated serum human chorionic gonadotropin (hCG) levels, and characteristic features on transvaginal ultrasound. Timely and accurate diagnosis is essential for initiating prompt treatment and preventing medical complications. Uterine evacuation, preferably via vacuum aspiration, is the treatment of choice due to its high efficacy and safety profile. Adjunctive techniques, such as hysteroscopy and intraoperative ultrasonography, enhance the safety and effectiveness of uterine evacuation and should be available to patients, especially at specialized referral centers equipped to manage this diagnosis. In selected cases, particularly in women with fulfilled reproductive goals or those at a high risk of developing post-molar gestational trophoblastic neoplasia (GTN), total abdominal hysterectomy is appropriate. Postoperative follow-up with serial measurements of hCG is essential for monitoring remission and for the early detection of post-molar GTN, which develops in approximately 20% of cases of complete molar pregnancies and 1–4% of partial molar pregnancies. This article provides a comprehensive review of the diagnosis of hydatidiform mole and the surgical techniques employed in the treatment of this condition, emphasizing individualized care and the use of appropriate surgical strategies to treat complications associated with this trophoblastic disease.

Introdução: A atenção primária tem importante papel na prevenção e no tratamento de doenças infecciosas como sífilis, vaginose bacteriana, candidíase, Aids e tricomoníase, já que, no contexto gestacional, algumas dessas doenças podem determinar graves complicações ao recém-nascido, podendo levar à morte fetal. Objetivo: Avaliar a frequência de fluxos genitais patológicos na gravidez. Materiais e métodos: Trata-se de um estudo de corte transversal no qual foram estudadas 299 gestantes atendidas no serviço de pré-natal em Juiz de Fora e 66 gestantes atendidas em Barbacena, ambas em Minas Gerais. Resultados: O fluxo genital patológico foi identificado em 127 pacientes (34,7%), sendo a vaginose bacteriana (n=53; 14,5%) e a candidíase (n=67; 18,3%) as mais comuns. Não houve caso de tricomoníase. Conclusão: Vaginose bacteriana e candidíase são as responsáveis pelos fluxos genitais patológicos mais comuns em ambos os serviços.

Gestational trophoblastic disease (GTD) comprises a heterogeneous group of disorders arising from abnormal proliferation of placental trophoblastic tissue. This spectrum includes benign forms, prim...