scholarly journals Video Hysteroscopy in the Diagnosis of Molar Pregnancy in two Challenging Situations: Complete Mole with Normal hCG and Partial Mole with Early Gestational Age

2021 ◽  
Author(s):  
Antonio Braga ◽  
Lilian Padrón ◽  
Jacir Luiz Balen ◽  
Kevin M. Elias ◽  
Neil S. Horowitz ◽  
...  
Keyword(s):  
Gestational Age ◽  
Molar Pregnancy ◽  
Complete Mole ◽  
Partial Mole

scholarly journals PRENATAL DIAGNOSIS AND POSTNATAL MANAGEMENT OF THE COMPLETE MOLAR PREGNANCY WITH COEXISTING NORMAL FETUS

2021 ◽  
pp. 26-27
Author(s):  
A . Nagarani ◽  
Dantam Hymavathi Devi
Keyword(s):  
Prenatal Diagnosis ◽  
Preterm Delivery ◽  
Hydatidiform Mole ◽  
Molar Pregnancy ◽  
Postnatal Management ◽  
Normal Fetus ◽  
Rare Phenomenon ◽  
Complete Mole ◽  
Partial Mole

Hydatidiform mole with a coexisting fetus is an extremely rare phenomenon; the incidence of such an occurrence ranges from 1 in 10 000 to 1 in 100000 gestations(Cunningham et al., 1997).There were two possible conditions:a partial mole with an abnormaltriploid fetus, and a complete mole combined with a normal fetus and placenta. Most cases suffer severe complications, such as pre-eclampsia, abortion and preterm delivery,or termination immediately after the diagnosis.

scholarly journals Outcome of gestational trophoblastic disease in a rural tertiary centre of Haryana, India

2016 ◽  
Vol 6 (1) ◽  
pp. 271 ◽  
Author(s):  
Pinkey Lakra ◽  
Vijayata Sangwan ◽  
Sunita Siwach ◽  
Richa Kansal ◽  
Rajiv Mahendru ◽  
...  
Keyword(s):  
Single Agent ◽  
Gestational Trophoblastic Disease ◽  
Tertiary Centre ◽  
Complete Mole ◽  
Vaginal Deliveries ◽  
Partial Mole ◽  
Tertiary Center ◽  
The Mean ◽  
Prophylactic Chemotherapy ◽  
Poor Reporting

Background: The reported incidence of GTD varies widely worldwide, from a low of 23 per 100,000 pregnancies (Paraguay) to a high of 1,299 per 100,000 pregnancies (Indonesia). The reported incidence of GTD in India is inconsistent therefore we planned to do an analysis of the GTD at our institute which is a referral tertiary center of Haryana.Methods: Records of patients of GTD admitted from January 2014 to June 2016 were analyzed and incidence per 1000 deliveries was calculated. The demographic profile, clinical presentation, management and complications were studied.Results: There were 38 patients of GTD with an incidence of 2.3 per 1000 deliveries. Out of 38 patients 33 (86.8%) were of molar pregnancy and 5 (13.16%) had GTN. Out of 33 molar patients 27 (81.8%) had complete mole and 6 (18.2%) had partial mole. All cases of GTN were low risk and received single agent methotrexate based chemotherapy. The mean age was 23.02±2.96 years and 47.4% were primigravida. The mean gestational age of presentation was 13.84 ± 3.24 weeks. There were no mortalities and no recurrences. Education in more than half i.e. 57.1% patients was below primary and 7 of the 19 patients with GTD, who could be followed telephonically, were found to have not followed the contraceptive advice and conceived within 6 months of the treatment of molar pregnancies, 5 had vaginal deliveries of live babies one of which was preterm and rest 2 had spontaneous abortions.Conclusions: In view of poor reporting from developing countries there is a need for a nodal centre exclusively for GTD in each state. Poor compliance and contraceptive practice due to uneducated population especially in rural India, warrants a need for prophylactic chemotherapy in high risk cases.

scholarly journals Partial molar pregnancy with live fetus in first trimester: what should we do next

2020 ◽  
Vol 20 (2) ◽  
Author(s):  
Eric Edwin ◽  
Uki Retno Budihastuti ◽  
Cut Sheira Elnita
Keyword(s):  
Hydatidiform Mole ◽  
First Trimester ◽  
Postnatal Period ◽  
Molar Pregnancy ◽  
Antenatal Consultation ◽  
Partial Mole ◽  
Close Observation ◽  
Live Fetus ◽  
Multiple Cysts

Abstract. The incidence of a normal live fetus with a partial mole is extremely rare, and it varies between 5 per 100000 and 1 per 10000 of the pregnancies. A partial molar pregnancy is a variation of a molar pregnancy in which an embryo either develops incompletely or with multiple structural anomalies.A 27-year-old Primigravide at 13 weeks of gestation got admitted with spotting per vaginam, excessive nausea and vomiting, and her ultrasound revealed a hydropic placenta with multiple cysts with a live fetus. Regarding these findings, the patient continued her pregnancy under close observation, and advanced sonographic evaluations were done to rule out other differentials. Ultrasonography found mosaicism in the partial mole (mostly diploid, a small part is triploid). In this condition, the prognosis condition for the fetus to be born safely is still probable. Ethics committee meetings are held with the consideration of the fetus's condition, whether monitoring is carried out regularly, and terminating the pregnancy in case of fetal emergency.The optimal management of hydatidiform mole with the coexistent live fetus is currently uncertain. Antenatal consultation should include a detailed discussion of maternal and fetal risks. It is also necessary to have close follow-up and evaluation of the patient's condition during the antenatal and postnatal period. Keywords: first trimester, live fetus , management, partial molar pregnancy

scholarly journals Ectopic tubal pregnancy with partial mole: a rare case

2018 ◽  
Vol 7 (4) ◽  
pp. 1651
Author(s):  
Nanda Patil ◽  
Robina Mohamed Nazeer ◽  
Jyoti Tele
Keyword(s):  
Fallopian Tube ◽  
Gold Standard ◽  
Rare Case ◽  
Clinicopathological Features ◽  
Histopathological Study ◽  
Molar Pregnancy ◽  
Abnormal Fertilization ◽  
Partial Mole ◽  
Placental Villi ◽  
Hydatidiform Moles

Hydatidiform moles are abnormal gestations characterised by the presence of hydropic changes in the placental villi associated with circumferential trophoblastic proliferation. They arise due to abnormal fertilization. Molar gestation commonly develops within the uterus but presence of molar changes in ectopic pregnancy is extremely rare. Author present a rare case of ectopic molar pregnancy in fallopian tube in a 20 years old female patient to highlight its clinicopathological features. Ectopic molar pregnancy in a fallopian tube is very rare and histopathological study is the gold standard for the exact diagnosis and further management. 

scholarly journals Histopathological examination of tissues following a surgical uterine evacuation in the first trimester bleeding: clinical relevance

2020 ◽  
Vol 10 (3) ◽  
pp. 91-94
Author(s):  
Bandana Khanal ◽  
Basant Sharma ◽  
Renuka Tamrakar ◽  
Prekshya Singh
Keyword(s):  
Clinical Relevance ◽  
Histopathological Examination ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Complete Mole ◽  
Products Of Conception ◽  
Partial Mole ◽  
History Of

Background: There is no general consensus about the role of routine HPE of the obtained tissue at the time of uterine evacuation. However, it is understood clinically that it is of utmost importance to prove the presence of intrauterine gestation and to exclude gestational trophoblastic disease in the form of partial or complete mole. This study aimed to assess the role of histopathology in cases of first trimester miscarriages and to determine clinical relevance of histopathological examination following surgical evacuation. Methods: This was a retrospective study of collected data over 12 months (January 2018- De­cember 2018) in an agency for reproductive health setup with predefined inclusion criteria. We included 60 consecutive patients attended with history of first trimester bleeding. Patient’s record and the histopathological examination report of products of conception following uterine evacu­ation were observed. The data was analyzed descriptive statistics including percentage, stander deviation, mean, and range in Microsoft Excel software. Results: Missed abortion was the most common type and constituted 55% of the studied group. The histopathological reports confirmed the pregnancy in all patients and revealed partial mole in 6(10%) patients and complete mole in 2(3.33%) patients. Conclusions: Histopathological examination of products of conception detects under diagnosed molar pregnancies that necessitates special follow up and is a key step to do further management.

scholarly journals Combination of Immunohistochemistry and Ploidy Analysis to Assist Histopathological Diagnosis of Molar Diseases

2008 ◽  
Vol 1 ◽  
pp. CPath.S601 ◽  
Author(s):  
M.C. Osterheld ◽  
L. Caron ◽  
P. Chaubert ◽  
K. Meagher-Villemure
Keyword(s):  
Histological Analysis ◽  
Protein A ◽  
Image Cytometry ◽  
First Trimester ◽  
Internal Controls ◽  
Histopathological Diagnosis ◽  
Complete Mole ◽  
Products Of Conception ◽  
Partial Mole ◽  
Hydropic Abortion

Background Differential diagnosis between hydropic abortion, partial mole and complete mole is still a challenge for pathologists but really important for patient management. Material and Method In this study, we have evaluated 111 products of conception from the first trimester. Histological analysis was made according to the main diagnostic histopathological features described in the literature and the cases were categorized in hydropic abortus (HA), partial mole (PM) and complete mole (CM). Immunohistochemistry was performed using monoclonal antibody against p57kip protein a putative paternally imprinted inhibitor gene and DNA ploidy was analysed in all cases by image cytometry. Results All 23 HAs presented a diploid DNA content and were p57kip2 positive. From the 28 CMs, 12 cases (43%) were diploid and 16 cases (57%) were tetraploid but no expression of p57kip2 was found with positive internal controls. From the 60 PMs, 58 cases were positive for p57kip2 expression and 53 cases (88%) were triploid, 6 cases (10%) tetraploid and 1 case (2%) diploid. Conclusion This study on 111 cases of early pregnancies confirms the usefulness of immunohistochemistry and cytometry but demonstrates the importance of the combination of both techniques to assist histology for the best reliable diagnosis.

scholarly journals Role of the Immunohistochemical Marker (Ki67) in Diagnosis and Classification of Hydatidiform Mole

2020 ◽  
Vol 18 (3) ◽  
Author(s):  
Hasan Abu Deka FF ◽  
Abd Ali Al Saeng ZH ◽  
Khalid Almukhtar Z
Keyword(s):  
Stromal Cells ◽  
Hydatidiform Mole ◽  
Labeling Index ◽  
Statistical Relationship ◽  
Ki 67 ◽  
Cross Sectional ◽  
Complete Mole ◽  
Partial Mole ◽  
Hydropic Abortion

Introduction: Since the hallmark of gestational trophoblastic disease is trophoblastic proliferation, Ki67 is regarded as the best marker in studying hydatidiform mole.This study was conducted to evaluate the role of this proliferative marker in distinguishing among hydropic abortion, partial and complete hydatidiform mole. Materials and methods: This is a cross sectional study involving the application of Ki67 on a total of 90 histological samples of curetting materials from molar (partial and complete mole) and non molar hydropic abortion belong to Iraqi females, so three study groups were created. Immunohistochemical expression in villous cytotrophoblasts, syncytiotrophoblasts and stromal cells were recorded separately by three independent observers and the results were correlated statically. Results: The mean number of stained nuclei of villous cytotrophoblasts and stromal cells was the highest in complete mole and the lowest in non molar hydropic abortion. There is a significant statistical relationship regarding Ki67 labeling index in villous cytotrophoblasts between partial moles and hydropic abortion, complete mole and partial moles, hydropic abortion and complete mole. Regarding Ki67 labelling index in villous stromal cells, a significant statistical relationship achieved when the correlation done between partial mole and hydropic abortions, hydropic abortion and complete mole, while a non significant statistical relationship was achieved if the correlation done between partial and complete mole. All villous syncytiotrophoblasts showed negative results. Conclusion: Ki-67 labeling index in villous cytotrophblastic cells are useful in separating between partial moles and hydropic abortion, partial mole and complete mole, hydropic abortion and complete mole. While Ki-67 labeling index in villous stromal cells is only useful in separating between partial moles and hydropic abortion, hydropic abortion and complete mole.

scholarly journals GESTATIONAL TROPHOBLASTIC DISEASES;

2012 ◽  
Vol 19 (02) ◽  
pp. 159-161
Author(s):  
SYED MEHMOOD HASSAN ◽  
SHOAIB NAYYER I HASHM ◽  
BUSHRA AYAZ ◽  
Faisal Rashid Lodhi ◽  
Kanwal Sohail
Keyword(s):  
Hydatidiform Mole ◽  
Age Groups ◽  
Gestational Trophoblastic Disease ◽  
Trophoblastic Disease ◽  
Complete Mole ◽  
Trophoblastic Diseases ◽  
Partial Mole ◽  
Gestational Trophoblastic Diseases ◽  
Data Source ◽  
Naval Hospital

Objective: The study was carried out to evaluate the frequency and types of gestational. Trophoblastic diseases (GTD) inendometrial curettings received for histopathology examination. Data Source: Pathology Department, Shifa Naval Hospital Karachi. Design ofStudy: It was a Retrospective Descriptive Observational study. Setting: Department of Pathology, Pakistan Naval Ship; Shifa Naval HospitalKarachi. Period: From 2009 till 2010. Material & Methods: A total of 170 cases of endometrial curettage were examined. All specimensreceived with a diagnosis of product of conceptions (POC) or with the clinical suspicion of a gestational trophoblastic disease were included.Results: It was observed that partial mole identified in 57.1 % cases followed by complete mole 21.4%, choriocarcinoma 14.2% and placentalsite Trophoblastic disease 7.1% cases. Nearly half of the cases were diagnosed as having a gestational trophoblastic disease; these were fromthe age groups of 26-30 years followed by 21-25 years. Conclusions: Hydatidiform mole is the commonest gestational trophoblastic disease.Most complete moles are detected clinically but partial moles are misdiagnosed as abortions therefore all cases of abortions should be sent forhistopathological examinations.

scholarly journals Clinicopathological study of Gestational Trophoblastic Disease

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2344-2349
Author(s):  
Ramesh M. Oswal ◽  
Mahendra A. Patil ◽  
Sujata M. Kumbhar ◽  
Jyoti S. Tele ◽  
Atul B. Hulwan
Keyword(s):  
Risk Factors ◽  
Maternal Age ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Histopathological Study ◽  
Molar Pregnancy ◽  
Complete Hydatidiform Mole ◽  
Trophoblastic Disease ◽  
Complete Mole ◽  
Clinicopathological Study

Several potential etiologic risk factors have been evaluated for the development of complete hydatidiform mole. The two established risk factors that have emerged are extremes of maternal age and prior molar pregnancy. Advanced or very young maternal age has consistently correlated with higher rates of complete hydatidiform mole. Compared to women aged 21- 35 years, the risk of a complete mole is 1.9 times higher for women both more than 35 years and less than 21 years as well as 7.5 times higher for women more than 40 years. (49, 50) The risk of repeat molar pregnancy after 1 mole is about 1% or about 10-20 times the risk for the general population. The present study on the gestational trophoblastic disease (GTD) was carried out as it is one of the fascinating gynaecological tumours. Hence a clinicopathological study of gestational trophoblastic disease was undertaken with relevance to the histopathological study of GTD and clinical correlation.

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