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Molar pregnancy is a gestational trophoblastic disease that belongs to the category of precancerous lesions. On the other end of the spectrum are gestational trophoblastic neoplasms such as invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor, which are considered malignant tumors. Based on defined histopathological criteria, molar pregnancy is divided into partial and complete hydatidiform mole. Especially in the case of early complete mole, the diagnosis can be quite challenging and often necessitates additional molecular or immunohistochemical methods. The aim of this study was to assess the importance of additional molecular and immunohistochemical methods to accurately diagnose complete hydatidiform mole and to stress the importance of correct diagnosis and close follow-up of these patients. A total of 367 consecutive cases of spontaneous abortion were analyzed in a 3-year period. Eight cases with histopathological diagnosis of complete molar pregnancy were selected for further analysis. Apart from standard microscopic analysis, additional molecular and immunohistochemical analyses were performed in all eight cases. Most of the histopathological characteristics of complete molar pregnancy were present in all cases, together with complete absence of positivity for the p57 immunohistochemical marker in the cytotrophoblasts and villous stromal cells. The molecular analysis revealed androgenetic diploidy in seven cases and biparental diploidy in one case with more than three consecutive complete molar pregnancies. Additional immunohistochemical and molecular methods can considerably aid in the correct diagnosis of molar pregnancy.

Using a variety of molecular techniques, it has been established that loss of pregnancy occurs in one to two thirds of all fertilized embryos in the first trimester. In about 50% of the cases, chromosomal abnormalities are the cause of early spontaneous abortion. Several histological characteristics of the placenta, such as presence of villous stromal cavitations, fetal erythrocytes, umbilical cord, fetal tissue, etc. are suggested as predictive factors for aneuploidy. Two hundred and thirty one cases were analyzed in this prospective study, 50 cases were control artificial abortions and 181 cases were early spontaneous abortionsanalyzed in the period from May 2012 to December 2014. Standard histopathological analysis and molecular techniques based on polymerase chain reaction were used to analyze the samples. Usingmolecular techniques, aneuploidy was detected in 53.1% of the samples. The most frequently detected aneuploidy was trisomy 16, followed by trisomy 22, 21, 14 and 18. The molecular analysis also enabled distinction of maternal and paternal origin of the alleles. In the histopathological sample analysis, binary logistic regression analysis indicated the presence of trophoblastic proliferation (p=0.008) and the absence of fetal red blood cells (p=0.001) as independent significant factors in the prediction of aneuploidy in early spontaneous abortion. In conclusion, our results show that clinically relevant and accurate diagnosis of early spontaneous abortion which can determine its causecan only be achieved bya controlled process of selection of the material, histo-pathological and molecular analysis, followed bya necessary correlation of these results.

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