Presentation
Medical records were reviewed and incidence, clinical presentation and method of diagnosis were studied. [jnma.com.np]
This study presents the first use of preimplantation genotyping to ensure biparental inheritance in a woman presenting with recurrent diandric complete hydatidiform mole. [ncbi.nlm.nih.gov]
Entire Body System
- Falling
Complete hydatidiform mole (CHM) is a type of molar pregnancy and falls at the benign end of the spectrum of gestational trophoblastic disease. CHM is the commonest type of gestational trophoblastic disease. [radiopaedia.org]
Treatment Surgical dilation and curettage monitor β-hCG following treatment should fall to zero Medical methotrexate Prognosis, Prevention, and Complications Choriocarcinoma may progress to choriocarcinoma more common in complete moles Uterine rupture [medbullets.com]
The majority of these pregnancies appear to fall in one of two distinct syndromes: 1) a “twin gestation”, in which it is theorised that one gestation develops normally with normal karyotype while the second undergoes complete molar degeneration (i.e. [jpgmonline.com]
What if my levels do not fall? In ten per cent of cases, the hormone levels do not decrease to normal. This is called persistent trophoblastic disease. [thewomens.org.au]
The treatment graph shows the fall and normalization of the hCG level with low dose methotrexate chemotherapy treatment. The patient has completed treatment, gone on to have a healthy baby and has been cured of this malignancy,” by openi. [lecturio.com]
- Anemia
Other factors include the size of the molar placenta, the speed of molar degeneration and fetal anemia. [2] The cases we report probably had sufficient placental circulation to sustain through the first and second trimester, however, had neonatal anemia [ijpmonline.org]
Patients with PM had lower pre-evacuation serum human chorionic gonadotropin levels (P < 0.001), and they were also less likely to present with vaginal bleeding (P < 0.001), biochemical hyperthyroidism (P < 0.001), anemia (P < 0.001), uterine size greater [ncbi.nlm.nih.gov]
Medical Complications of Hydatidiform Mole Common complications include anemia, infection, hyperthyroidism, pregnancy-induced hypertension or pre-eclampsia, and theca lutein cysts. Anemia : A hemoglobin of less than 10 g/dL, seen in 50% of patients [slideshare.net]
A molar pregnancy puts you at risk for anemia, hyperthyroidism, and gestational hypertension. The abnormal tissue may grow through the lining of your uterus and into muscle. This may cause bleeding into your abdomen or pelvis. [drugs.com]
[…] normal, but it is not as high as with other types of GTD An HCG test can help find GTD after pregnancy or miscarriage as this hormone should not be present in the blood or urine soon afterward Complete blood count Complete blood count can check for anemia [wikidoc.org]
- Weight Loss
Case Report A 20-year-old woman, gravida 2, para 1, presented to the emergency room with a history of nausea, weight loss of about 20 lb in 6 weeks, and intermittent vaginal bleeding. [thyroid.org]
loss Symptoms similar to preeclampsia that occur in the first trimester or early second trimester, including high blood pressure and swelling in the feet, ankles, and legs (this is almost always a sign of a hydatidiform mole, because preeclampsia is [medlineplus.gov]
She may have hyperthyroidism (overproduction of thyroid hormones causing symptoms such as weight loss, increased appetite, and intolerance to heat). Sometimes, the grapelike cluster of cells itself will be shed with the blood during this time. [medical-dictionary.thefreedictionary.com]
Systemic symptoms, including fatigue, tiredness and weight loss, are frequently reported. [lecturio.com]
Weight loss. Tests that examine the uterus are used to detect (find) and diagnose gestational trophoblastic disease. [northshore.org]
- Asymptomatic
- M alignan… Endometrial (uterine) polyp -May be asymptomatic or... -Painless abnormal uterine bleeding. [quizlet.com]
Vaginal bleeding was the most common symptom seen in 86% cases while anaemia was seen in 70% cases. 9% patients were asymptomatic and were diagnosed on USG. [ispub.com]
Cardiovascular
- Hypertension
A triplet pregnancy in a 23-year-old woman was terminated at 15 weeks of gestation because of her severe hypertension, lung edema, and secondary hyperthyroidism. [ncbi.nlm.nih.gov]
Medical Complications of Hydatidiform Mole Common complications include anemia, infection, hyperthyroidism, pregnancy-induced hypertension or pre-eclampsia, and theca lutein cysts. Anemia : A hemoglobin of less than 10 g/dL, seen in 50% of patients [slideshare.net]
Skin
- Alopecia
(Table 6) Figure 8 Table 6 Time taken for regression of serum β-HCG No serious side effect was associated with prophylactic chemotherapy. 2 cases had alopecia, 1 had nausea and vomiting and 1 had hepatic toxicity. No death due to toxicity occurred. [ispub.com]
Neurologic
- Confusion
It is for this reason that the mole may remain undetected or be confused with following conditions: 1- Missed abortion: The picture most easily confused with a postmolar GTN is a spontaneous abortion because what is seen are echo-refringent and non-homogeneous [ultrasoundtraining.com]
Because complete mole is now commonly detected at a stage before the development of its classical diagnostic features, the histological features of complete mole at an early gestation are frequently confused with partial mole, hydropic miscarriage or [e-immunohistochemistry.info]
Since you can completely confuse incomplete mole and complete mole, here's a memory aid for you! The trick is to remember one & the other one, is the other one. We'll remember complete mole. A complete mole is completely paternal. [medicowesome.com]
Although this decrease in uterine artery pulsatility may be of some use in diagnosing confusing cases that occasionally clinically mimic other conditions ( eg, threatened abortion or uterine atony ) (19,20), the persistently elevated beta- hCG level will [fetalultrasound.com]
Because it can be found growing in the cervix, it can also sometimes be confused with cervical cancer. [cancer.org]
Urogenital
- Cesarean Section
She underwent cesarean section and delivered a live infant. By close follow-up and a multidisciplinary approach, the appropriate diagnosis and a favorable outcome were achieved. Both mother and the child at 5 years of age are doing well. [ncbi.nlm.nih.gov]
Workup
The metastatic workup was negative and the patient was treated with weekly intramuscular methotrexate at 30 mg/m2. The hCG levels declined appropriately and then plateaued. [ncbi.nlm.nih.gov]
With rapidly increasing acquirement of molecular diagnostic capabilities at most medical centers, DNA genotyping should become an integral component of the routine diagnostic workup of both complete and partial hydatidiform moles. [omicsonline.org]
Persistent cysts warrant appropriate workup and 26. Pulmonary distress : is observed in 2% of patients. [slideshare.net]
If malignancy is suspected, workup must include an x-ray of the chest to screen for lung metastases. Hydatidiform moles are normally treated via dilation and curettage, whereas choriocarcinoma typically requires chemotherapy. [amboss.com]
Differential diagnosis of a hydatidiform mole From a diagnostic point of view, a workup for spontaneous abortion should also be carried out, since this can also cause bleeding in early pregnancy. [lecturio.com]
Urine
- Albuminuria
Med 2009;3:15 ) Disproportionately large uterus for the stage of pregnancy Increasing serum hCG levels after the 14th week, as opposed to the drop typically seen in the course of normal gestation Evidence of toxemia of pregnancy (hypertension, edema, albuminuria [pathologyoutlines.com]
Excessive development of the luteal tissue in the ovaries and significantly increased secretion of the latter, on the one hand, and the activities of syncytium - on the other, lead to the fact that women molar there are a number of symptoms (edema, albuminuria [medicalency.com]
Excessive development of luteal tissue in the ovaries and significantly increased secretion of the latter, on the one hand, and the activities of the syncytium – on the other, lead to the fact that women have been in a molar range of symptoms (edema, albuminuria [survinat.com]
Treatment
Treatment and prognosis Suction and curettage are used for evacuation are usually the routine treatment. Serial beta-hCG levels should be obtained until it reaches zero, as it is the main indicator of residual disease. [radiopaedia.org]
[…] until hCG plateau or increase did not affect outcomes, with no uterine perforations or treatment failures. [ncbi.nlm.nih.gov]
Treatment for a molar pregnancy If an ultrasound scan shows that you have a molar pregnancy, treatment to remove it will be recommended. [nhs.uk]
Prognosis
Treatment and prognosis Suction and curettage are used for evacuation are usually the routine treatment. Serial beta-hCG levels should be obtained until it reaches zero, as it is the main indicator of residual disease. [radiopaedia.org]
OBJECTIVE: To examine whether preeclampsia is a predictive factor for fetal prognosis in complete hydatidiform mole coexistent with twin fetus (CHMCF). [ncbi.nlm.nih.gov]
Follow-up and prognosis of these women does not differfrom otherwomen with complete hydaticliform moles 3. References 1. Suzuki, M., Masunobu, A., Wakita, K. et at. Hydatidiform molewith a surviving cocxistrngfoetus. Obstet. [jpma.org.pk]
Prognosis Moles may progress to persistent trophoblastic disease, placental site trophoblast tumour and choriocarcinoma. The incidence of persistent disease is far more common for complete moles (10-30%) than it is for partial moles (0.5-5%). [e-immunohistochemistry.info]
Management of the pregnancy in such rare conditions should be determined on one-to-one basis and the possibility of increased complications should be discussed with the family and prognosis explained. [ijpmonline.org]
Etiology
[…] an invasive mole Etiology Risk factors Prior molar pregnancy History of miscarriage Patients ≤ 15 and ≥ 35 years Complete mole Does not contain any fetal or embryonic parts Caused by fertilization of an empty egg that does not carry any chromosomes → [amboss.com]
Etiology of choriocarcinoma Choriocarcinoma frequently develops from a hydatidiform mole or following a spontaneous abortion; occasionally, it also occurs after a normal pregnancy. [lecturio.com]
Etiology and pathogenesis THE DRIFT OF THE GALLBLADDER (MOLA HYDATIDOSA) Defeat fleecy shell of the ovum with the transformation of the latter into a conglomerate of small bubbles of various sizes. Etiology and pathogenesis is not known. [lecheniebolezni.com]
A few studies have looked at the over- or underexpression of genes that may play a role in the progression or invasiveness of hydatidiform moles; however none have addressed the underlying genetic etiology. [clinicaltrials.gov]
Our data demonstrate that patients with recurrent hydatidiform moles and no mutations in the known genes are, in general, different from those with mutations; they have a milder genetic susceptibility and/or a multifactorial etiology underlying their [embryology.med.unsw.edu.au]
Epidemiology
Incide… Gynecologic tumor epidemiology - Incide… Gynecologic tumor epidemiology - Worst… -Due to blockage of Bartholin gland duc… endometrial > ovarian > cervical cervical > endometrial > ovarian... [quizlet.com]
Author information 1 Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 2 Department of Pathology, Myong-JI General Hospital, Goyang-si, Gyeongi-do, Korea. 3 Department of Clinical Epidemiology and Biostatistics [ncbi.nlm.nih.gov]
PubMed Google Scholar 13.2 Grimes DA : Epidemiology of gestational trophoblastic disease. Am J Obstet Gynecol 150:309–318, 1984. [link.springer.com]
Epidemiology of choriocarcinoma Choriocarcinoma is one of the rarest carcinomas occurring in the female genital tract. It accounts for around 1 % of all female tumors. [lecturio.com]
Epidemiology of hydatidiform mole during early gestation. Am J Obstet Gynecol. 1986 Apr. 154(4):906-9. [Medline]. Grimes DA. Epidemiology of gestational trophoblastic disease. Am J Obstet Gynecol. 1984 Oct 1. 150(3):309-18. [Medline]. [emedicine.medscape.com]
Pathophysiology
CONCLUSION: MRI could provide important information about the prenatal differential diagnosis of CHMTF and PMD, based on the pathophysiology and characteristics of the diseases. © 2014 The Authors. [ncbi.nlm.nih.gov]
Pathophysiology Hydropic degeneration of chorionic villi with concomitant proliferation of cytotrophoblasts and syncytiotrophoblasts → death of the embryo Clinical features Complete mole Vaginal bleeding during the first trimester Uterus size greater [amboss.com]
Pathophysiology of Disease, 5th ed., p. 639. ↑ Robbins and Cotran's Pathological Basis of Disease, 7th ed., p. 1112 ↑ Title of page. Website title (date). [wikidoc.org]
Pathophysiology: A complete mole contains no fetal tissue. 90% are 46XX and 10% are 46XY. All chromosomes are of paternal origin. [csh.org.tw]
Pathophysiology of Disease: An Introduction to Clinical Medicine (Lange). McGraw-Hill Medical. p. 639. ISBN 0-07-144159-X. ^ MedlinePlus Encyclopedia Hydatidiform mole ^ Paoloni-Giacobino A. (2007). "Epigenetics in reproductive medicine". Pediatr. [en.wikipedia.org]
Prevention
Selection of male embryos is therefore unlikely to prevent repetitive CHM in this patient. [ncbi.nlm.nih.gov]