Factors Associated With Clinical Management and Posttreatment Follow-Up Compliance in Patients With Hydatidiform Mole: A Single-Center Retrospective Study From Vietnam

Background: Hydatidiform mole (HM) is a benign trophoblastic disease in which early diagnosis, timely treatment, and strict adherence to posttreatment follow-up are essential to achieve remission and ensure early detection of gestational trophoblastic neoplasia (GTN). Reports on HM in Vietnam remain limited and inconsistent. This study aimed to describe the incidence and clinical features of HM and to analyze factors associated with mole subtype, treatment, and follow-up compliance at a tertiary obstetrics and gynecology hospital in Hanoi. Methods: A retrospective case study was conducted among patients diagnosed and treated at Hanoi Obstetrics and Gynecology Hospital between January 1, 2020, and December 31, 2021. Demographic, clinical, and diagnostic data were collected from medical records. Descriptive analyses characterized the study population, and univariate and multivariate logistic regression models identified factors associated with treatment decisions and follow-up compliance. Results: A total of 205 patients were diagnosed and treated for HM, corresponding to an incidence of 3.6 per 1000 deliveries. In 50 cases, histopathology confirmed HM without subclassification; therefore, only the remaining 155 patients were included in subgroup and association analyses. Complete hydatidiform moles (CHM) and partial hydatidiform moles (PHM) accounted for 71.6% and 28.4%, respectively. Maternal age showed a strong association with mole type: CHM predominated in women aged ≥40 years, whereas PHM occurred more frequently in younger patients. Invasive moles occurred in 16.1% of cases. Hysterectomy was performed in 29.0% of patients, and 34.2% received methotrexate (MTX) chemotherapy. Factors associated with hysterectomy included maternal age ≥40 years, CHM, and a pre-evacuation β-human chorionic gonadotropin (β-hCG) level ≥100,000 IU/L. Prophylactic chemotherapy was also correlated with older age, CHM, and invasive mole. Only 54% of patients completed follow-up with at least three consecutive negative β-hCG measurements, and chemotherapy administration was a significant factor associated with improved compliance. Conclusions: Posttreatment follow-up completion among patients with HM remains suboptimal, which may explain the relatively high rates of surgical and chemotherapeutic interventions observed. Strengthening patient education, surveillance, and adherence to follow-up protocols is crucial for improving treatment outcomes for molar pregnancy in Vietnam.