Comprehensive Study on Patients with Molar Pregnancy Referred to Mahdieh Hospital in Tehran: A Descriptive and Retrospective Research

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Background: Hydatidiform mole is a rare but clinically significant pregnancy abnormality. This study was undertaken to improve understanding of molar pregnancy risk factors in the Iranian population and to develop strategies for early detection and management. It also aimed to evaluate the impact of Methotrexate (MTX) chemoprophylaxis on progression to Gestational Trophoblastic Neoplasia (GTN). Methods: This single-center, retrospective descriptive study was conducted at Mahdieh Hospital in Tehran between 2011 and 2023. A total of 449 patients with histopathologically confirmed molar pregnancies were included. Detailed clinical and laboratory data were collected and analyzed using SPSS (version 26), with significance set at p<0.05. GTN was diagnosed according to FIGO criteria, based on serial β-hCG monitoring (rising or plateauing levels) and confirmed by histopathological examination. Results: The incidence was 6.75 per 1,000 pregnancies. Anemia and vaginal bleeding were the most common presenting symptoms. Complete moles accounted for 66.6% of cases. Among 18 patients who received MTX prophylaxis, elevated β-hCG levels and larger uterine size were significantly associated with MTX administration (p<0.001). However, MTX prophylaxis did not significantly prevent progression to GTN (p=0.365). During follow-up, 11 patients developed GTN. Conclusion: Molar pregnancies in Iran exhibited a higher incidence compared to developed countries. The limited benefit of prophylactic MTX in this small subgroup support the need for larger, multicenter studies to refine treatment protocols.

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