The clinical records of all molar patients were reviewed regarding presentation, treatment, and follow-up. [ncbi.nlm.nih.gov]

• Pain

  Most patients presented with abdominal pain and/or vaginal bleeding (67%). Ectopic pregnancy was diagnosed by ultrasound scan in 19%. [ncbi.nlm.nih.gov]

  If it spreads to your lungs, you may have symptoms such as coughing, difficulty breathing and chest pain. [nhs.uk]

  The pain a mother experiences at the loss of a pregnancy is never comparable to any pain in the world. [nurseslabs.com]

  […] often show some of the following signs: Vaginal bleeding during the first trimester of pregnancy Uterine size larger than expected for the length of pregnancy Severe nausea and vomiting More rarely, women with advanced GTD may have severe abdominal pain [cedars-sinai.edu]

• Anemia

  Anemia. Anemia results from a woman’s body being unable to replace red blood cells as fast as she is losing them. Unusual abdominal swelling. Severe vomiting. Overactive thyroid gland. Bleeding accompanied by severe abdominal pain. [cancerschmancer.org]

  Risk factors Extremes of maternal age (very young or advanced age) Prior history of GTD Signs and Symptoms Pelvic pain or pressure Anemia Hyperemesis gravidarum (excessive vomiting during early pregnancy) Hyperthyroidism Missed menstrual period with elevated [froedtert.com]

  Presenting symptoms may vary depending on the type of malignancy but include vaginal bleeding, uterine enlargement, pelvic pain, anemia, hyperemesis gravidarum, hyperthyroidism and early preeclampsia. [2minutemedicine.com]

  Signs and Symptoms: Clinical manifestations of GTD include, in decreasing order of frequency: Vaginal bleeding Enlarged uterus Pelvic pressure or pain Theca lutein cysts Anemia Hyperemesis gravidarum Hyperthyroidism Preeclampsia before 20 weeks of gestation [alaskawomenscancercare.com]

• Pathologist

  This book will be of great value to pathologists, community gynecologists, gynecological pathologists and medical students. [springer.com]

• Infertility

  Immature defence mechanisms also significantly predict infertility-related global stress. Conclusions. [moh-it.pure.elsevier.com]

  Depression, anxiety, and infertility-related stress were assessed using the Beck Depression Inventory-Short Form, the State-Trait Anxiety Inventory, and the Fertility Problem Inventory, respectively. [ncbi.nlm.nih.gov]

• Hypertension

  More-severe indications of disease include abdominal swelling (abnormal uterine enlargement for the stage of perceived pregnancy), preeclampsia (an acute hypertensive condition), and vaginal bleeding. [britannica.com]

  The "weight" of fetal growth restriction in 437 hypertensive pregnancies. [preeclampsia.it]

  White WB (1984) Management of hypertension during lactation. Hypertension 6:297–300 PubMed Google Scholar 149. American College of Obstetricians and Gynecologists (2001) Chronic hypertension in pregnancy. [link.springer.com]

  Pregnancy-associated hypertension is present in approximately 30% of cases of complete HM. [scielo.br]

  The presentation is variable: uterus larger than pregnancy age abnormally high β-hCG hyperemesis hypertension theca-lutein cysts A common characteristic of all gestational trophoblastic disease is an abnormal proliferation of trophoblast, but different [radiopaedia.org]

• Seizure

  Pulmonary secondaries may give rise to dyspnea, cough and hemoptysis, while cerebral metastases may manifest as headache, hemiparesis and seizures. The other common sites of metastasis are the vagina and liver. [prognosisapp.com]

  If it spreads to your brain, it may cause headaches or seizures. Chemotherapy is used to treat choriocarcinoma and usually successfully cures it. [nhs.uk]

  […] villi → risk of hemorrhage and early metastasis ( lung, vagina, brain, liver ) Clinical features Postpartum vaginal bleeding and inadequate uterine regression after delivery Theca lutein cysts Additional symptoms depend on the site of metastasis (e.g., seizures [amboss.com]

  You may also be given magnesium sulfate via your vein to reduce the risk for seizures. [healthline.com]

• Irritability

  Feeling anxious or irritable. Weight loss. Tests that examine the uterus are used to detect (find) and diagnose gestational trophoblastic disease. [cancer.gov]

• Tremor

  […] cysts Pre-eclampsia: may indicate a complete molar pregnancy; signs include high blood pressure, swelling in the hands and feet and headaches Vomiting Hyperthyroidism: may indicate a complete molar pregnancy; signs include high HCG blood levels, mild tremors [loyolamedicine.org]

  […] experiences during a normal pregnancy fatigue and shortness of breath due to anemia resulting from blood loss through vaginal bleeding faster growth than expected for weeks of pregnancy, due to extension of the uterus rapid heartbeat, warm skin, and mild tremor [mskcc.org]

  Symptoms include: tachycardia, hypertension, tremors, tachypnea, weight loss, heat intolerance, muscle weakness, diarrhea, nervousness, and hyper-reactive reflexes. [scielo.br]

  Note : Clinical hyperthyroidism defined as TSH –1 and signs/symptoms consistent with hyperthyroidism (tachycardia, tremor and breathlessness) requiring treatment with anti-thyroid drugs (one case with HCG 100 000–500 000 IU l –1 at presentation and three [doi.org]

• Vaginal Bleeding

  Choriocarcinomas typically present with irregular vaginal bleeding, pelvic pain and symptoms of metastatic disease. [prognosisapp.com]

  More-severe indications of disease include abdominal swelling (abnormal uterine enlargement for the stage of perceived pregnancy), preeclampsia (an acute hypertensive condition), and vaginal bleeding. [britannica.com]

  Patients with GTD frequently present with vaginal bleeding and pelvic tenderness. Complete hydatidiform moles are associated with several additional clinical features (e.g., enlarged uterus, hyperemesis gravidarum, preeclampsia ). [amboss.com]

  Pulmonary, vulval, or vaginal metastases unless hCG concentrations are falling. Heavy vaginal bleeding or evidence of GI or intraperitoneal haemorrhage. [patient.co.uk]

  bleeding in the absence of other symptoms is most common presentation CHM Most frequently diagnosed in first half of pregnancy Most common symptom is abnormal vaginal bleeding – usually 6-16 weeks gestation Other symptoms include the following Uterine [arupconsult.com]

• Uterine Hemorrhage

  Its use may help avoid invasive interventions, such as hysterectomy and embolization, currently used to control hemorrhage after uterine evacuation. [ncbi.nlm.nih.gov]

  Hydatidiform Mole Many patients with complete mole present with or develop anemia from uterine hemorrhage and may require transfusion support. [clinicaladvisor.com]

• Urinary Incontinence

  Written by a board of authoritative and high-profile experts, the book covers all aspects from urinary incontinence and overactive bladder, to fistulae and reconstructive surgery. [libreriacortinamilano.it]

Recently, PCR-based short tandem repeat DNA genotyping has emerged as a powerful diagnostic measure in the workup of gestational trophoblastic disorders, particularly hydatidiform moles. [ncbi.nlm.nih.gov]

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]

Metastatic workup:• Includes:• Xray chest and CT scan• USG and CT scan abdomen and pelvis• CT or MRI scan of head• hCG levels can be measured in CSF to exclude cerebral involvement if CT brain is normal.• Ratio of plasma to CSF hCG has to be lower than [slideshare.net]

See Workup for more detail. Management Patients with GTN are subdivided into 2 groups: those with a WHO score of less than 7 (low-risk) and those with a score of 7 or higher and who are at high risk of therapy failure. [emedicine.medscape.com]

• Trophoblastic Cells

  Epithelioid trophoblastic tumor is a distinctive but rare trophoblastic tumor. It derives from intermediate trophoblastic cells of the chorion laeve and is usually associated with a previous gestational event. [ncbi.nlm.nih.gov]

  During fertilization, trophoblastic cells invade the endometrium, blood vessels and myometrium to establish fetomaternal circulation. In a normal pregnancy, a large number of trophoblasts circulate in the mother's blood system. [oncolex.org]

  What is gestational trophoblastic disease? Gestational trophoblastic disease (GTD) is a collection of abnormal cell growths and tumors within the cells of a woman’s uterus. [cancer.coloradowomenshealth.com]

Invasive moles may spontaneously regress, or they may require additional treatment. [britannica.com]

Expert Review of Obstetrics and Gynecology: treatments for gestational trophoblastic disease (2010) [prognosisapp.com]

When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Clinical trials are taking place in many parts of the country. [cancer.gov]

However, it is associated with significant neutropenia often requiring dose reductions and treatment delays. We describe the use of granulocyte colony-stimulating factor (G-CSF) in three patients in order to maintain the treatment schedule. [ncbi.nlm.nih.gov]

Currently, prognosis and treatment is decided using the WHO prognostic score. Patients with a WHO score of 6 or less have excellent prognosis and are initially treated with single agent chemotherapy. [emedicine.medscape.com]

A patient with metastatic, poor prognosis disease and a large metastatic lesion on her left fifth digit is presented. The clinical course and complete response to EMACO chemotherapy are outlined. [ncbi.nlm.nih.gov]

or 18 months for patients with a poor prognosis. [giog.it]

Prior evidence shows that FIGO score ≥7 is associated with poorer prognosis. [2minutemedicine.com]

This case has interesting etiologic implications, but it is difficult to make any extrapolation from this very peculiar case in terms of definition/quantification of maternal and paternal components in the development of gestational trophoblastic disease [ncbi.nlm.nih.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 → [amboss.com]

Etiology The etiology of gestational trophoblastic tumors is not known. [rarediseases.info.nih.gov]

We describe the current understanding of the morphology, epidemiology and genetics of gestational trophoblastic disease that followed the milestone findings by Kajii and Ohama. Copyright © 2012 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]

Numero Pagine: 205 Rilegatura: Rilegato Formato: 25x31 Prezzo Copertina: € 150.55 Sconto 15% Descrizione Comprehensive presentation of histological diagnosis and differential diagnoses of GTD In-depth reviews of the molecular genetic background of GTD, epidemiology [libreriascientifica.com]

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]

Some comments about diabetes mellitus are made regarding: history, pathophysiology, value of glucose tolerance tests, dietary management and preferred methods of delivery. [link.springer.com]

Pathophysiology Fertilization occurs as the sperm enters the ovum. In instances of a partial mole, two sperms might fertilize a single ovum. Reduction division or meiosis was not able to occur in a partial mole. [nurseslabs.com]

[…] hydatidiform molar pregnancy Asian or American Indian ancestry, or (for GTN only) African ancestry Older maternal age – women >40 years Familial disease – rare, more common in recurrent CHM NLRP7 and (rarely) KHDC3L gene mutations implicated (Wang, 2009) Pathophysiology [arupconsult.com]

Triploid partial moles which arise mainly from dispermic fertilization may also be prevented by ICSI. [ncbi.nlm.nih.gov]

Causes & Prevention NCI does not have PDQ evidence-based information about prevention of gestational trophoblastic disease. Screening NCI does not have PDQ evidence-based information about screening for gestational trophoblastic disease. [cancer.gov]