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Complete Hydatidiform Mole

Molar Pregnancy


Presentation

  • 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]
Turkish
  • Our objectives were to genotype the molar tissue and identify the NLRP7 mutations in two unrelated Turkish women with recurrent CHM.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Ultrasonography and computed tomography showed large multicystic ovaries, marked ascites, and large pleural effusions that required placement of bilateral chest tubes. She had recovered by hospital day 14.[ncbi.nlm.nih.gov]
Cough
  • A 33-year-old multiparous woman with suspected CHMCF was admitted with a severe cough. Computed tomography revealed multiple lung metastases.[ncbi.nlm.nih.gov]
Abdominal Pain
  • The patient underwent a caesarean section at twenty eight weeks for maternal distress due to unbearable abdominal pain. The baby died after seven days.[ncbi.nlm.nih.gov]
Lower Abdominal Pain
  • A 23-year-old woman, gravida 1, para 1, was transferred to our hospital with acute lower abdominal pain and vital signs consistent with shock. Her urine concentration of human chorionic gonadotrophin was 8000 mIU/mL.[ncbi.nlm.nih.gov]
Second Trimester Bleeding
  • We present a case of a molar pregnancy with a euploid fetus who had close fetal evaluation for second trimester bleeding. The patient presented at 29 weeks' pregnancy with decreased fetal movements, a result of fetomaternal hemorrhage.[ncbi.nlm.nih.gov]
Short Arm
  • To our knowledge, this is the first case report of complete hydatidiform mole with coexisting fetus diagnosed by variation of the acrocentric short arms, followed by termination with intravaginal gemeprost.[ncbi.nlm.nih.gov]
Long Arm
  • DNA probes specific for the pericentromeric regions of chromosomes 1 and X and for the long arm of chromosome Y were used. In four cases a dizygotic twin pregnancy could be proven.[ncbi.nlm.nih.gov]
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]
Oliguria
  • Post operatively she had an eclamptic fit and developed oliguria and persistent trophoblastic disease which were all successfully treated.[ncbi.nlm.nih.gov]
  • Post operatively she had an eclamptic fit and developed oliguria and persistent trophoblastic disease which were all successfully treated. Key words : hydatidiform mole, living fetus, perisitent trophoblastic disease.[ajol.info]
Encephalopathy
  • We describe cortical blindness and posterior reversible encephalopathy syndrome (PRES) complicating molar pregnancy-related eclampsia.[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]
  • Persistent cysts warrant appropriate workup and 26.  Pulmonary distress : is observed in 2% of patients.[slideshare.net]
  • 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]
  • 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]
  • 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]
Ovarian Mass
  • In the clinical setting of a markedly elevated human chorionic gonadotropin level and an ovarian mass, histopathologic examination is critical in distinguishing ectopic pregnancy from choriocarcinoma.[ncbi.nlm.nih.gov]
  • -endometrial hyperplasia Theca-lutein cyst Most common ovarian mass in young women Follicular cyst Distention of unruptured graafian folli… Follicular cyst[quizlet.com]
Brain Edema
  • Preeclampsia and eclampsia are regarded as common causes of PRES, which is considered to be the result of vasogenic brain edema caused by a rapid raise in blood pressure. Clinical and imaging findings are usually reversible.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Ultrasonography and computed tomography showed large multicystic ovaries, marked ascites, and large pleural effusions that required placement of bilateral chest tubes. She had recovered by hospital day 14.[ncbi.nlm.nih.gov]

Treatment

  • […] until hCG plateau or increase did not affect outcomes, with no uterine perforations or treatment failures.[ncbi.nlm.nih.gov]
  • Seven day rest between treatment cycles.[molarpregnancy.co.uk]
  • Fortunately, these tumors are often curable with appropriate treatment and after treatment, a patient's fertility is often preserved. Even the most advanced cases of GTT are often curable with the right treatment.[verywell.com]
  • 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

  • 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]
  • 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]
  • 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]
  • 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]
  • 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]

Etiology

  • 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]
  • 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]
  • […] 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 The ([amboss.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]
  • Fluorescent in situ hybridization (FISH) on paraffin-embedded placental tissues as an adjunct for understanding the etiology of early spontaneous abortion. Prenat Diagn 2005;25:314-7. [ PubMed ] Caramins MC, Saville T, Shakeshaft R, et al.[tp.amegroups.com]

Epidemiology

  • 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]
  • - Incide… Gynecologic tumor epidemiology - Incide… Gynecologic tumor epidemiology - Worst… -Due to blockage of Bartholin gland duc… endometrial ovarian cervical cervical endometrial ovarian...[quizlet.com]
  • 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]
Sex distribution
Age distribution

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: 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, 5th ed., p. 639. Robbins and Cotran's Pathological Basis of Disease, 7th ed., p. 1112 Title of page. Website title (date).[wikidoc.org]
  • The comparison of findings in androgenetic CHM and PHM indicate that both maternally (under) expressed and paternally (over) expressed genes play a role in the pathophysiology of molar pregnancies.[clinicaltrials.gov]
  • 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]
  • […] histology Differential Diagnosis Partial Mole Missed abortion Choriocarcinoma Treatment Treatment involves evacuation of uterine contents by dilation and curettage Alternatively, patients who do not desire further fertility may opt for a hysterectomy to prevent[learningradiology.com]

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