Hysteroscopy improves surgical outcomes of hydatidiform moles while reducing postoperative residuals

To evaluate the clinical efficacy of hysteroscopy in the treatment of molar pregnancy and postoperative residual tissue.

This retrospective study involved 68 patients who underwent treatment for molar pregnancy in Shanxi Children's Hospital Shanxi Maternal and Child Health Hospital from April 2020 to May 2022. Based on intervention methods, patients were divided into a conventional group (n=33) and a hysteroscopy group (n=35). The effects of different treatment methods on perioperative outcomes, prognosis, serum factor levels and complication rates were compared between the two groups.

The comparison of general data, including age, gestational times, the number of patients with a cleared uterus, and the time interval from the last menstruation to hysteroscopic surgery, showed no significant differences between the two groups (all P > 0.05). The operation duration and menstrual recovery time of the hysteroscopy group were significantly shorter than those of the conventional group, and the intraoperative blood loss was significantly less than that in the conventional group (all P < 0.05). After surgery, endometrial thickness in hysteroscopy group was significantly thinner than that in conventional group (P < 0.05), though there was no significant difference in uterine adhesion rates (P > 0.05). Before surgery, there was no significant difference in serum factor levels between the two groups (P > 0.05). After surgery, the levels of β-human chorionic gonadotropin (β-HCG), creatine kinase (CK), trend factor interleukin-10 (CXCL10), and placental growth factor (PlGF) in the hysteroscopic group were all lower than those in the conventional group (all P < 0.05), while pregnancy-associated plasma protein-A (PAPP-A) was higher. The cure rate in the hysteroscopy group was significantly higher, while the total incidence of complications was significantly lower than those in the conventional group (all P < 0.05).

Hysteroscopic treatment for molar pregnancy effectively removes lesions, reduces the treatment load, and provides the potential to preserve fertility function.