Presentation
The clinical records of all molar patients were reviewed regarding presentation, treatment, and follow-up. [ncbi.nlm.nih.gov]
Fetus
- Absence of Fetal Heart Tones
The absence of fetal heart tones, a uterus too large for the estimated gestational age and presence of theca lutein cysts on physical examination further support the diagnosis. [1], [2], [12] Honeycomb appearance on ultrasound scan was observed in 84% [tjogonline.com]
[…] of fetal parts on palpation or roentgenogram in a uterus of such a size that one would expect such findings Absence of fetal heart tones at a time when, by gestational duration or size, they would be expected to be audible Characteristic ultrasonographic [glowm.com]
Skin
- Warm Skin
skin, and mild tremor or shaking; caused by an overactive thyroid gland, this complication may occur rarely in women with high HCG levels preeclampsia (also known as toxemia)—a pregnancy-related condition which can cause a sharp rise in blood pressure [mskcc.org]
skin and mild shaking seen rarely in patients with complete mole. [foundationforwomenscancer.org]
skin, and mild shaking seen rarely in patients with complete mole High blood pressure due to preeclampsia (also called toxemia of pregnancy), which can develop if the molar pregnancy continues beyond twelve weeks Women who develop choriocarcinoma may [mymolarpregnancy.com]
Psychiatrical
- Suggestibility
The latter suggests a hitherto unreported novel link between ASPP1 and the extrinsic pathway of apoptosis. [ncbi.nlm.nih.gov]
Findings (eg, very high beta-hCG levels, classic ultrasonographic findings) may suggest the diagnosis, but biopsy is required. [merckmanuals.com]
Neurologic
- Focal Neurological Deficit
Contn..• VAGINAL(30%): suburethral, highly vascular and may bleed vigorously when biopsied.• HEPATIC(10%): painful enlargement, intraperitoneal hemorrhage may occur.• CNS(10%): may develop focal neurological deficits. 19. [slideshare.net]
Urogenital
- 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]
- Sexual Dysfunction
Psychological morbidity rates exceeded community norms, but sexual dysfunction rates, although high, are likely consistent with local norms. [ncbi.nlm.nih.gov]
Workup
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.com]
Treatment
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]
Prognosis
Prior evidence shows that FIGO score ≥7 is associated with poorer prognosis. [2minutemedicine.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]
The prognosis can sway from good to poor, depending on its stage. [thebabycorner.com]
Only a few women with GTD have a poor prognosis, e.g. some forms of stage IV GTN. The FIGO staging system is used. [en.wikipedia.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 The etiology of gestational trophoblastic tumors is not known. [rarediseases.info.nih.gov]
This article seeks to address recent advances in the genetics of GTN in relation to diagnosis, etiology, prognosis and treatment. [ncbi.nlm.nih.gov]
Epidemiology
The epidemiology, pathology, clinical presentation, and diagnosis of each of these trophoblastic disease variants are discussed. [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
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 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]
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]
[…] 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]
Prevention
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]
While GTD cannot be prevented, you should get HCG tests and regular prenatal tests if you are at risk. Most cases of GTD are completely treatable, even if they are not found in the earliest stages. [loyolamedicine.org]