220. Exceedingly rare presentation of gestational trophoblastic disease: Molar pregnancy implantation in Caesarean scar

2018 ◽  
Vol 13 ◽  
pp. S102
Author(s):  
Patrick Harrington
Keyword(s):  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Rare Presentation ◽  
Caesarean Scar ◽  
Trophoblastic Disease

scholarly journals Choriocarcinoma with uterine rupture presenting as acute haemoperitoneum and shock

2017 ◽  
Vol 6 (3) ◽  
pp. 1141 ◽  
Author(s):  
Mamour Gueye ◽  
Mame Diarra Ndiaye Gueye ◽  
Ousmane Thiam ◽  
Youssou Toure ◽  
Mor Cisse ◽  
...  
Keyword(s):  
Young Woman ◽  
Uterine Rupture ◽  
Gestational Trophoblastic Disease ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Rare Neoplasm ◽  
Trophoblastic Disease ◽  
Intraperitoneal Bleeding ◽  
Invasive Mole

Choriocarcinoma is a rare neoplasm and a malignant form of gestational trophoblastic disease. Invasive mole may perforate uterus through the myometrium resulting in uterine perforation and intraperitoneal bleeding. But uterine perforation due to choriocarcinoma is rare. We present a case of a young woman who presented 1 year after uterine evacuation of a molar pregnancy with invasive choriocarcinoma complicated by a uterine rupture and haemoperitoneum.

A Study of Molar Pregnancy at Low Resource Settings of Tertiary Care Hospital Sindh

2021 ◽  
Vol 15 (7) ◽  
pp. 1547-1549
Author(s):  
Sabahat Fatima ◽  
A. G.ul Shaikh ◽  
Tahmina Mahar ◽  
Hameed-Ur-Rehman Bozdar ◽  
Sameena Memon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Economic Status ◽  
Gestational Trophoblastic Disease ◽  
Common Symptom ◽  
Care Hospital ◽  
Molar Pregnancy ◽  
Socio Economic Status ◽  
Trophoblastic Disease

Aim: To determine the epidemiological factors/characteristics and clinical presentation of molar pregnancy Study design: Qualitative observational / retrospective study Place and duration: Department of Obstetrics and Gynaecology Unit-II, Ghulam Muhammad Mahar Medical College Sukkur from 1st January 2016 to 31st December 2020. Methodology: Forty five diagnosed cases with molar pregnancy and aged between 18-40 years were enrolled. Patient’s details demographics age, body mass index, parity and socio economic status were recorded. The total birth records and gynecological admission for the study period were also collected from the gynaecology and labour room record books case and operational registration data were obtained, descriptive statistics examined . Results: Mean age of the patients was 31.15±7.41 years with mean body mass index 26.16±7.22 kg/m2. Mean gestational age of the patients were 25.62±9.19 weeks. Twenty seven (60%) patients were multiparous and 18 (40%) were primiparous. 30 (66.7%) were illiterate and 15(33.3%) cases were literate. There were 14(31.11%) patients belonged lower class, 18 (40%) patients belonged middle and 13(28.9%) had high socioeconomic status. Twenty nine (64.4%) were from rural area and 16 (35.6%) were from urban area. Five (11.1%) patients had previous history of gestational trophoblastic disease. Abnormal vaginal bleeding was the most common symptom found in 34(75.5%) cases followed by lower abdominal pain found in 30 (66.7%) patients, hyperemesis found in 14(31.1%) and dyspnea in 9 (20%). Thirty six (80%) patients received suction evacuation and 9 (20%) cases referred. Forty one (91.1%) patients were recovered but the rest 4 (8.9%) were lost during follow up. Conclusion: Low/middle socio-economic status, illiteracy and cases from rural areas had multiparous parity was highly effected by molar pregnancy disease and it can be controlled by early diagnose to take regular follow-up by using suction evacuation. Key words: Gestational trophoblastic disease (GTD), Molar pregnancy, Primiparous, Multiparous

scholarly journals Ultrasound diagnosis of molar pregnancy

Ultrasound ◽  
2018 ◽  
Vol 26 (3) ◽  
pp. 153-159 ◽  
Author(s):  
Jackie A. Ross ◽  
Alina Unipan ◽  
Jackie Clarke ◽  
Catherine Magee ◽  
Jemma Johns
Keyword(s):  
Likelihood Ratio ◽  
Gestational Trophoblastic Disease ◽  
Ultrasound Diagnosis ◽  
Histopathological Diagnosis ◽  
Molar Pregnancy ◽  
Diagnostic Challenge ◽  
Trophoblastic Disease ◽  
Post Test ◽  
Post Test Probability ◽  
Test Probability

Introduction The primary aims of this study were to establish what proportion of ultrasonically suspected molar pregnancies were proven on histological examination and what proportion of histologically diagnosed molar pregnancies were identified by ultrasound pre-operatively. The secondary aim was to review the features of these scans to help identify criteria that may improve ultrasound diagnosis. Methods This was a retrospective observational study conducted in the Early Pregnancy Unit at King’s College Hospital London over an 11-year period. Cases of ultrasonically suspected molar pregnancy or other gestational trophoblastic disease were identified and compared with the final histopathological diagnosis. In addition, cases which were diagnosed on histopathology that were not suspected on ultrasound were also examined. In discrepant cases, the images were reviewed unblinded by two senior sonographers. Statistical analysis for likelihood ratio and post-test probabilities was performed. Results One hundred eighty-two women had gestational trophoblastic disease suspected on ultrasound examination (1:360, 0.3%); 106/182 (58.2%, 95% CI 51.0 to 65.2%) had histologically confirmed gestational trophoblastic disease. The likelihood ratio for gestational trophoblastic disease after a positive ultrasound was 607.27, with a post-test probability of 0.628.The sensitivity of ultrasound for gestational trophoblastic disease was 70.7% (95% CI 62.9% to 77.4%) with an estimated specificity of 99.88% (95% CI 99.85% to 99.91%); 102/143 (71.3%, 95% CI 63.4 to 78.1%) molar pregnancies were suspected on pre-op ultrasound; 60/68 (88.2%, 95% CI 78.2 to 94.2%) of complete moles were suspected on pre-op ultrasound, compared with 42/75 (56.0%, 95% CI 44.7 to 66.7%) of partial moles. On retrospective review of the pre-op ultrasound images, there were cases that could have been suspected prior to surgery. Conclusion Detecting molar pregnancy by ultrasound remains a diagnostic challenge, particularly for partial moles. These data suggest that there has been an increase in both the predictive value and the sensitivity of ultrasound over time, with a high LR and post-test probability; however, the diagnostic criteria remain ill-defined and could be improved.

scholarly journals Gestational Trophoblastic Disease Presents as an Ectopic Tubal Pregnancy, a Rare Entity

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Haneen Al-Maghrabi ◽  
Daniyah Saleh ◽  
Abdelrazak Meliti
Keyword(s):  
Gold Standard ◽  
Histopathological Examination ◽  
Lower Abdominal Pain ◽  
Gestational Trophoblastic Disease ◽  
Low Grade ◽  
Molar Pregnancy ◽  
Fallopian Tubes ◽  
Rare Entity ◽  
Trophoblastic Disease ◽  
Laboratory Investigations

Ectopic molar pregnancy is an uncommon event in clinical practice. In this paper, we report a case of ectopic complete molar pregnancy in a 39-year-old lady who presented to the emergency department with lower abdominal pain, abdominal distention, and low-grade fever. Based on radiological and laboratory investigations, the differential diagnosis included ruptured ectopic pregnancy versus metastatic diseases. Ectopic hydatidiform molar pregnancies can occur at any extrauterine pelvic sites, yet more frequently affecting fallopian tubes. The histopathological examination remains the gold standard for the diagnosis.

The clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation

2004 ◽  
Vol 14 (2) ◽  
pp. 366-369 ◽  
Author(s):  
A. M. Gillespie ◽  
E. A. Lidbury ◽  
J. A. Tidy ◽  
B. W. Hancock
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Gestational Trophoblastic Disease ◽  
Surgical Removal ◽  
Molar Pregnancy ◽  
Initial Management ◽  
Trophoblastic Disease ◽  
Treatment Centre ◽  
History Of ◽  
Park Hospital

The objective of this study was to determine the clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation registered with the Trophoblastic Disease Screening and Treatment Centre, Weston Park Hospital, Sheffield between 1986 and 2000. From the 5581 women registered, those with a diagnosis of ectopic molar pregnancy were identified from a computer database. Information regarding the relevant history of each patient and the clinical presentation, treatment, and outcomes of gestational trophoblastic disease (GTD) was determined by reviewing referral forms, case notes, and pro formas completed by the referring gynecologist. Histological review of the cases was undertaken where possible. Suspected ectopic molar gestations comprised 31/5581 (0.55%) of registrations. Known risk factors for ectopic pregnancy were identified in 79% of cases. Central histological review confirmed only six cases of GTD: three choriocarcinoma and three early complete moles. Four patients subsequently required chemotherapy. All patients are now in complete remission. We conclude that ectopic GTD is uncommon, with a UK incidence of approximately 1.5 per 1,000,000 births. Initial management is usually surgical removal of the conceptus, pathological suspicion of the diagnosis and registration with a screening center. Chemotherapy may be required and the prognosis is excellent.

scholarly journals Coriocarcinoma gestacional primario de cuello uterino. Presentación de un caso

2021 ◽  
Vol 81 (04) ◽  
pp. 406-410
Author(s):  
Viviana García ◽  
◽  
Franco Calderaro Di Ruggiero ◽  
Jorge Hoegl ◽  
Carlos Quintero ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
World Health ◽  
Molar Pregnancy ◽  
Trophoblastic Disease ◽  
Gestational Choriocarcinoma ◽  
Gynecology And Obstetrics ◽  
Gynecological Examination

Choriocarcinoma represents a type of malignant tumor of gestational trophoblastic disease. It can develop after a molar pregnancy, miscarriage, normal or ectopic pregnancy. Generally its seat site is the uterine body; infrequent places such as the cervix have been described. We report the case of a 37-year-old patient is reported, VI gestations IV deliveries I cesarean section I molar pregnancy, with abnormal uterine bleeding, which is referred to the Hospital Oncology Service. On gynecological examination, an exophytic mass is observed in the cervix. A biopsy was taken that reported: Gestational choriocarcinoma and plasma levels of β-hCG were verified: 13805 IU / L. A total abdominal hysterectomy was performed with preservation of the ovaries. It was concluded as stage I of the International Federation of Gynecology and Obstetrics and 8, according to the score of the World Health Organization (ST I: 8), for which adjuvant was indicated. Currently no evidence of disease. Keywords: Choriocarcinoma, gestational trophoblastic disease, cervix.

scholarly journals Recurrent Thyroid Storm Caused by a Complete Hydatidiform Mole in a Perimenopausal Woman

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Anuradha Jayasuriya ◽  
Dimuthu Muthukuda ◽  
Preethi Dissanayake ◽  
Shyama Subasinghe
Keyword(s):  
Molecular Mimicry ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Thyroid Storm ◽  
High Dose ◽  
Complete Hydatidiform Mole ◽  
Free Triiodothyronine ◽  
Rare Presentation ◽  
Perimenopausal Woman ◽  
Trophoblastic Disease

Background. Gestational trophoblastic disease (GTD) which includes hydatidiform mole, invasive mole, placental site trophoblastic tumor, and choriocarcinoma is a rare cause of hyperthyroidism due to excess production of placental human chorionic gonadotrophin hormone (hCG) by tumor cells. Molecular mimicry between hCG and thyroid stimulating hormone (TSH) leads to continuous stimulation of TSH receptor by extremely high levels of hCG seen in these tumors. Consequently, biochemical and clinical hyperthyroidism ensues and it is potentially complicated by thyrotoxic crisis which is fatal unless urgent therapeutic steps are undertaken. Case Description. We present a 49-year-old perimenopausal woman who presented with recurrent thyroid storm and high output cardiac failure. The initial workup revealed suppressed TSH, high-free thyroxine (FT4), and free triiodothyronine (FT3) levels with increased vascularity of the normal-sized thyroid on ultrasonography. She was managed with parenteral beta blockers, steroids, and high-dose carbimazole. Her lower abdominal tenderness led to further investigations which revealed tremendously elevated beta-hCG and a snow storm appearance on transabdominal ultrasound suggestive of GTD. She underwent curative surgery and was diagnosed with complete hydatidiform mole postoperatively by histology. Conclusion. Recurrent thyroid crisis in gestational trophoblastic disease is an exceedingly rare presentation and that is highly fatal. This case highlights the importance of early detection and treatment of the etiology of thyrotoxicosis to eliminate mortality.

Successful use of anti-retroviral therapy in combination with cytotoxic chemotherapy for persistent molar pregnancy: A case report

2003 ◽  
Vol 13 (2) ◽  
pp. 246-248
Author(s):  
M. Moodley ◽  
J. Moodley
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Young Women ◽  
Ethical Dilemmas ◽  
Gestational Trophoblastic Disease ◽  
Cytotoxic Chemotherapy ◽  
Molar Pregnancy ◽  
Trophoblastic Disease ◽  
Response To Chemotherapy

Due to the HIV pandemic, the chances of finding gynecological malignancies in HIV-infected women are increased. This poses management and ethical dilemmas as the treatment for such malignancies are likely to further decrease their immunity. Gestational trophoblastic disease occurs predominantly among young women and has excellent response to chemotherapy. However, such therapy is not possible if their immunity (CD4 counts) is markedly depressed. The patient described presented with persistent molar pregnancy and had low CD4 count. She was given antiretroviral therapy and once the CD4 count had risen to acceptable levels cytotoxic chemotherapy was administered. She received a total of 13 cycles of chemotherapy with no significant untoward effects. After a 6-month follow-up period the patient was well with a negative serum βHCG level and CD4 count above 200. We conclude that HIV-infected women with gestational trophoblastic disease may be safely treated with cytotoxic chemotherapy provided anti-retroviral therapy is concurrently administered to boost immunity.

Gestational trophoblastic disease: Experience at a tertiary care center from a developing country

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16041-16041
Author(s):  
R. Hariprasad ◽  
K. Ganessan ◽  
A. Gupta ◽  
L. Kumar ◽  
S. Kumar ◽  
...  
Keyword(s):  
High Risk ◽  
Actinomycin D ◽  
Care Center ◽  
Tertiary Care ◽  
Risk Groups ◽  
Gestational Trophoblastic Disease ◽  
Low Risk ◽  
Molar Pregnancy ◽  
Excellent Outcome ◽  
Trophoblastic Disease

16041 Background: We retrospectively analyzed case records of patients diagnosed to have Gestational Trophoblastic Disease (GTD) to determine clinical characteristics, risk groups, treatment outcome, and reproductive function post treatment. Methods: Between Jan 1991 to Dec 2005, 102 patients (mean age: 28.2 years, range 19–50) were diagnosed to have GTD. 35 patients were nulliparous and 8 had prior molar pregnancy. Vaginal bleeding was the most common presenting symptom (77.5%). The antecedent pregnancy was vesicular mole in 50%, abortion - 34.3%, ectopic pregnancy - 4% and term pregnancy in 11.8% patients. The mean value of B hCG was 1225386 mIU/ml. The histopathology (n=85) was complete mole in 30, partial mole - 28, invasive mole- 9, PSTT -1 and choriocarcinoma in 17 patients. 68(66.7%) patients had non-metastatic disease. Sites of metastasis were - lung (38.2%), vagina (11%), brain (8.8%), liver (6.9%) and kidney, Urinary bladder and peritoneum in one patient each. According to modified WHO risk scoring - 78(76.5% had low risk and 24 (23.5%) were high risk. Results: Eighty-seven (85.3%) patients received chemotherapy using methotrexate with leucovorin (n=63), EMA/CO (n=19) and BEP (n=5). 77/87 (89.5%) achieved complete remission (CR) ; the response rate was higher in non-metastatic GTD (p<0.05). Two of 7(28.6%) patients with liver and 5/9 (55,6%) of brain metastasis achieved CR. Two patients had grade III oral mucositis and diarrhoea with methotrexate. One patient died of Methotrexate hypersensitivity. 19 patients received second line chemotherapy using EMA/CO (n=11), EMA/EP (n=2), BEP (n=1), actinomycin-D (n=1) and MAC (methotrexate, actinomycin D and Cyclophosphamide) n=1; 14 patients achieved CR. At a mean follow up of 180 months, 5-year survival for patients with low risk is 100% and that of high risk is 95%. Eight patients had recurrent disease including recurrent molar pregnancy in four. 16 patients had 24 successful deliveries after completion of treatment and 10 of them were primiparae. No fetal abnormalities were found. We did not observe second malignancy or other therapy related sequele. Conclusions: Present study confirms excellent outcome for patients with gestational trophoblastic disease. The potential for childbearing is well maintained. No significant financial relationships to disclose.

Pregnancy-Related Emergencies

2019 ◽  
Author(s):  
Amy Hideko Kaji
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Gestational Trophoblastic Disease ◽  
Treatment Modalities ◽  
Free Fluid ◽  
Molar Pregnancy ◽  
Hypertensive Disorders Of Pregnancy ◽  
Trophoblastic Disease ◽  
Hypertensive Disorders

This review provides an overview of spontaneous abortion, ectopic pregnancy, gestational trophoblastic disease or molar pregnancy, hyperemesis gravidarum, placental abruption, placental previa, hypertensive disorders of pregnancy, and amniotic fluid embolism. Assessment and stabilization, diagnosis, treatment and disposition, and outcomes are discussed. Tables include classifications of abortion or miscarriage, differential diagnosis of patients presenting with vaginal bleeding during pregnancy, risk factors for ectopic pregnancy, treatment modalities for hyperemesis gravidarum, classification of hypertensive disorders of pregnancy, and risk factors for preeclampsia and eclampsia. Figures show ectopic pregnancy on a sonogram, free fluid in hepatorenal fossa on a focused abdominal sonogram in trauma, double decidual sign in a normal intrauterine pregnancy, pseudogestational sac in an ectopic pregnancy, and “snowstorm” appearance of molar pregnancy on a sonogram. This review 5 figures, 13 tables, and 68 references. Keywords: abortion, ectopic, gestational trophoblastic disease, abruption, previa, ecclampsia

Sign in / Sign up

Export Citation Format

Share Document