Histopathological examination of the curettage material in nonviable pregnancies and evaluation of the frequency of hydatidiform mole

2021 ◽  
Author(s):  
Gulsah Dagdeviren ◽  
Funda Cevher ◽  
Busra Cendek ◽  
Salim Erkaya
Keyword(s):  
Histopathological Examination ◽  
Hydatidiform Mole

scholarly journals Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

2019 ◽  
Vol 12 (1) ◽  
pp. 25-30
Author(s):  
B Parajuli ◽  
G Pun ◽  
S Ranabhat ◽  
S Poudel
Keyword(s):  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
College Teaching ◽  
Histopathological Diagnosis ◽  
Age Group ◽  
Medical College ◽  
Dilatation And Curettage ◽  
Partial Mole ◽  
Proliferative Endometrium ◽  
The Common

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.

scholarly journals Partial hydatidiform mole evolving into metastatic trophoblastic tumor: case report

2020 ◽  
Vol 9 (4) ◽  
pp. 1713
Author(s):  
I. Elmouri ◽  
S. Tanouti ◽  
H. Taheri ◽  
H. Saadi ◽  
A. Mimouni
Keyword(s):  
Case Report ◽  
Therapeutic Strategy ◽  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
Myometrial Invasion ◽  
Multiparous Woman ◽  
Partial Hydatidiform Mole ◽  
Non Invasive ◽  
Trophoblastic Tumor ◽  
Partial Mole

Partial hydatidiform mole can evolve into a metastatic trophoblastic tumor. A 36-year-old, multiparous woman, pregnant with a 22-week embryonic hydatidiform mole, having spontaneously expelled. Histopathological examination showed a non-invasive partial mole. During biological monitoring, a trophoblastic tumor was diagnosed with pulmonary metastasis on CT-scan and myometrial invasion by MRI. Authors opted for a monochemotherapy with a good evolution. The potential risk of malignant transformation of the partial hydatidiform mole requires an adequate therapeutic strategy with strict monitoring.

scholarly journals Clinicohistological Correlation and Cost-effectiveness of routinely performed Histological Examination of Pregnancy Tissues obtained at Uterine Evacuation Procedure: Five-year Experience at a Secondary Care Hospital of Karachi, Pakistan

2017 ◽  
Vol 9 (1) ◽  
pp. 1-4
Author(s):  
Zaibunnisa Memon ◽  
Naureen Anjum ◽  
Sana Sadiq Sheikh
Keyword(s):  
Cost Effectiveness ◽  
Histological Examination ◽  
Secondary Care ◽  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
First Trimester ◽  
Care Hospital ◽  
Financial Benefit ◽  
Tissue Samples ◽  
Normal Product

ABSTRACT Aim To assess clinicohistological correlation and costeffectiveness of routinely performed histological examination of pregnancy tissue samples collected at surgical uterine evacuation Materials and methods In this retrospective study, medical record of patients admitted for incomplete miscarriage, missed miscarriage, and anembryonic miscarriage in the first trimester from January 2010 to August 2014 were reviewed. Histopathologic diagnosis of the tissue samples obtained via surgical uterine evacuation in these patients was compared with the preevacuation diagnosis. Results Specimens of 711 patients were sent after uterine evacuation. Histopathologic examination revealed normal product of conception in 681 patients (95.7%), while partial hydatidiform mole was diagnosed in 14 patients (1.9%). Complete hydatidiform mole was detected in only three cases (0.42%). Decidual tissue without chorionic villi was reported in 13 patients (1.8%). The diagnosis of complete mole was suspected in all three cases and in six cases of partial mole before procedure. Conclusion Findings of study did not show any diagnostic and financial benefit from routine histological examination of tissue removed at termination of pregnancy or emergency uterine evacuation. We recommend that histopathological examination be performed in cases where the diagnosis is uncertain, fewer tissues obtained during evacuation, when molar pregnancy is suspected, or when patients are considered at high risk for trophoblastic disease. How to cite this article Memon Z, Anjum N, Sheikh SS. Clinicohistological Correlation and Cost-effectiveness of routinely performed Histological Examination of Pregnancy Tissues obtained at Uterine Evacuation Procedure: Five-year Experience at a Secondary Care Hospital of Karachi, Pakistan. J South Asian Feder Obst Gynae 2017;9(1):1-4.

scholarly journals Clinical study of gestational trophoblastic disease in a tertiary care hospital

2020 ◽  
Vol 9 (7) ◽  
pp. 2964
Author(s):  
Jayashree Mulik ◽  
Archana Choudhary
Keyword(s):  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
Tertiary Care ◽  
Gestational Trophoblastic Disease ◽  
Care Hospital ◽  
Complete Mole ◽  
Trophoblastic Diseases ◽  
Study Centre ◽  
Gestational Trophoblastic Diseases ◽  
Chest X Ray

Background: Gestational trophoblastic diseases (GTDs) had been associated with significant morbidity and mortality till recently. Wide variation in incidences have been reported worldwide. The present study was planned with the objective of determination of incidence, assessment of risk factors, clinical presentation, management protocols and outcomes in GTD cases in Indian population at a tertiary care centre.Methods: All the diagnosed cases of GTD reporting to study centre during study period of 1.5 years were included. Detailed history taking, examination and relevant investigations (Hb%, blood grouping, thyroid functions, serum ß-hCG, USG and chest X-ray) were undertaken. Suction and evacuation were done for all patients as primary mode of management and samples were sent for histopathological examination. Comprehensive follow ups were done, including weekly ß-hCG until normal for 3 consecutive weeks followed by monthly determination until the levels were normal for 6 consecutive months.Results: Total 22 cases out of 19500 deliveries were diagnosed as GTD (incidence rate-1.13/1000 deliveries). Mean age was 23.64±3.89 years with 50% participants being primigravida. The commonest symptom after amenorrhea 22 (100%) was bleeding per-vaginum 15 (68.2%). Maximum cases were of complete hydatidiform mole histopathology 16 (72.73%), USG 19 (86.4%). Clinical characteristics were statistically comparable between patients of complete mole and partial mole. Out of 22 cases, 1 (4.5%) was diagnosed as GTN.Conclusions: Early diagnosis and treatment along with regular follow up is the key in GTD. There is need to establish a centralized disease specific registry in future.

scholarly journals Ovarian hyperstimulation syndrome following surgical removal of a complete hydatidiform mole: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Hiroaki Tsubokura ◽  
Yohei Ikoma ◽  
Takuya Yokoe ◽  
Tomoo Yoshimura ◽  
Katsuhiko Yasuda
Keyword(s):  
Ovarian Cyst ◽  
Ovarian Hyperstimulation Syndrome ◽  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
Ovarian Cysts ◽  
Surgical Removal ◽  
Ovarian Hyperstimulation ◽  
Complete Hydatidiform Mole ◽  
Multilocular Cyst ◽  
The Right

Abstract Background Generally, ovarian hyperstimulation syndrome develops after superovulation caused by ovulation-inducing drugs in infertile patients. However, ovarian hyperstimulation syndrome associated with natural pregnancy is rare, and most cases of ovarian hyperstimulation syndrome have been associated with a hydatidiform mole. Case presentation We describe a case of a 16-year-old Japanese girl with a complete hydatidiform mole. The patient was referred for intensive examination and treatment of the hydatidiform mole and underwent surgical removal of the hydatidiform mole at 9 weeks, 5 days of gestation. Histopathological examination revealed a complete hydatidiform mole. The patient’s blood human chorionic gonadotropin level decreased from 980,823 IU/L to 44,815 IU/L on postoperative day 4, and it was below the cutoff level on postoperative day 64. Transvaginal ultrasonography on postoperative day 7 revealed a multilocular cyst measuring 82 × 43 mm in the right ovary and a multilocular cyst measuring 66 × 50 mm in the left ovary. Both ovarian cysts enlarged further. Magnetic resonance imaging on postoperative day 24 revealed that the right multilocular ovarian cyst had enlarged to 10 × 12 cm and that the left multilocular ovarian cyst had enlarged to 25 × 11 cm. Blood examination showed an elevated estradiol level as high as 3482 pg/ml. We diagnosed the patient with bilateral giant multilocular cysts accompanied by ovarian hyperstimulation syndrome because of the rapid increase in the size of the cysts. The patient complained of mild abdominal bloating; however, symptoms such as nausea, vomiting, dyspnea, and abdominal pain were not observed. Therefore, we chose spontaneous observation in the outpatient clinic. The cysts gradually decreased and disappeared on postoperative day 242. Conclusion Physicians should be aware that ovarian cysts can occur and can increase rapidly after abortion of a hydatidiform mole. However, the ovarian cyst can return to its original size spontaneously even if it becomes huge.

Complementary role of p57kip2 immunostaining in diagnosing hydatidiform mole subtypes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nurzaireena Zainal ◽  
Nirmala Chandralega Kampan ◽  
Isa M. Rose ◽  
Razmin Ghazali ◽  
Mohamad Nasir Shafiee ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Paternal Genome ◽  
Tissue Samples ◽  
Cyclin Dependent Kinase Inhibitor ◽  
Ancillary Test ◽  
Complete Mole ◽  
Complementary Role

Abstract Objectives Gestational trophoblastic disease comprises of a spectrum of pregnancy-related tumours which includes complete (CHM) and partial hydatidiform moles (PHM). Accurate diagnosis and subclassification of HM subtypes are crucial as prognosis differs. Histopathological examination using haemotoxylin and eosin (H&E) staining remains the basis for diagnosing HM, with only 80% accuracy. p57kip2 is a cyclin-dependent kinase inhibitor (CDKI) protein and is strongly paternally imprinted, being expressed from maternal allele. Therefore, complete mole (CHM) with only paternal genome has nearly absent expression of p57kip2 compared to partial mole (PHM) having both paternal and maternal genomes. This study is aimed to determine usefulness of p57kip2 immunohistochemistry (IHC) analysis in the diagnosis of HM subtypes. Methods A total of 82 archived paraffin embedded HM tissues with subtypes classified based on H&E staining – 39 (47.5%) CHM, 41 (50.0%) PHM and two (2.43%) unclassified molar pregnancy were retrieved. All tissue samples were subjected for p57kip2 IHC analysis and HM subtypes were then reclassified. Results A total of 66 cases (80.5%) were re-classified as CHM, 14 cases (17.1%) as PHM and two cases (2.4%) were decidual and cystic tissues. Analysis using p57kip2 immunostaining showed a diagnostic discrepancy of 33.0% from routine H&E staining and helps to improve the characterisation of the HM subtypes specifically at early gestations which have less distinctive morphologies. Conclusions IHC using p57kip2 monoclonal antibody should be considered as a routine ancillary test to H&E in improving the diagnosis of HM subtypes particularly in developing countries with limited resources.

Partial Hydatidiform Mole with a Live Fetus— A Rare Entity

2009 ◽  
Vol 1 (3) ◽  
pp. 77-79
Author(s):  
Mahesh Koregol ◽  
Mrutyunjaya Bellad ◽  
Chandana Malapati
Keyword(s):  
Preterm Labor ◽  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
Rare Condition ◽  
Fetal Tissue ◽  
Partial Hydatidiform Mole ◽  
Partial Mole ◽  
Live Fetus ◽  
Live Baby ◽  
Rule Out

ABSTRACT Partial hydatidiform mole (PHM) with a singleton live fetus is a rare condition. A live baby of 2000 grams with many external congenital anomalies like hydrocephalus, bilateral congenital talipus equino varus (CTEV), meningomyelocele and spina bifida was delivered. Placenta weighed 700 grams and PHM was confirmed by histopathological examination. Baby expired one hour after birth. Baby was sent for autopsy which documented various anomalies. Partial hydatidiform mole is a histopathological entity characterized by focal trophoblastic hyperplasia with villous hydrops together with identifiable fetal tissue. PHM with a single live fetus is a rare condition which is reported by very few authors. Not all the cases of partial mole can be detected by USG/Doppler. If any anomalies are detected, PHM should be thought among the conditions possible. MShCG and karyotyping can be done to rule out this condition. Placenta has to be sent for histopathological examination to confirm the diagnosis of PHM. These patients are prone to go in preterm labor and preterm premature rupture of membranes (PPROM). There is possibility of malpresentations like transverse lie among these cases.

scholarly journals Histological analysis of the products of conception in first trimester spontaneous abortions

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Poonam Lama ◽  
Jitendra Pariyar
Keyword(s):  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Molar Pregnancy ◽  
Spontaneous Abortions ◽  
Cross Sectional ◽  
Products Of Conception ◽  
Decidual Reaction

Aims: To evaluate the histopathological findings of products of conception in the first trimester spontaneous abortions. Methods: A hospital based descriptive cross sectional study conducted from March 2018 to March 2019, among the women admitted with diagnosis of first trimester spontaneous abortion at Paropakar Maternity and Women’s Hospital. Results: Among 80 cases of spontaneous abortions, incomplete abortion was the commonest type constituting 42.5% of the studied group. The majority of participants belonged to age group of 21-30 years (61.2%) with a mean age of 26.8±6.1 years. Histopathologic examination confirmed products of conception in 60 (75%) patients, partial molar pregnancy in 9 (11.25%) patients, decidual reaction in 9 (11.25%) patients and hydropic abortus in only 2 (2.5%) patients. The molar pregnancy was more prevalent among women of Tibeto-Nepalese ethnic group 26.5% (n=9). Partial hydatidiform mole was more common in primiparous (19.3%) than in multiparous (14.2%). Conclusions: The histopathological examination of the products of conception proved to be an important tool in detecting undiagnosed pathology like molar pregnancy and hydropic changes that necessitate special follow-up protocol and further management.

scholarly journals The impact of pre-evacuation ultrasound examination in histologically confirmed hydatidiform mole in missed abortion

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yunhui Tang ◽  
Chenqi Zhu ◽  
Chen Zhu ◽  
Feng Liang ◽  
Arier Lee ◽  
...  
Keyword(s):  
Ultrasound Examination ◽  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
Lower Sensitivity ◽  
Missed Abortion ◽  
Naked Eye ◽  
Β Hcg ◽  
The Impact ◽  
Missed Opportunity ◽  
Higher Sensitivity

Abstract Background Early detecting hydatidiform mole in missed abortion is challenge. In this retrospective observational study, we analysed the sensitivity of detecting hydatidiform mole by pre-evacuation ultrasound examination or naked eye after surgical uterine evacuation in missed abortion. Methods Data on 577 cases with histologically confirmed hydatidiform mole were collected over a 10-year period and analysed. Data included serum β-hCG level before surgical evacuation, the ultrasound examination findings, histology findings and naked eye findings. In addition, serum β-hCG level on 2398 cases without hydatidiform mole was also collected. Results The median maternal age was 29 (range, 17–53) years and the range of gestational age was 6 to 12 weeks. The sensitivity of detecting hydatidiform mole by ultrasound examination or by naked eye was 25% or 60% respectively. This sensitivity was not increased by the combination of ultrasound and naked eye. There was no difference in the sensitivity of detecting subtypes of hydatidiform mole. The higher β-hCG level was seen in cases with hydatidiform mole, compared to cases without hydatidiform mole. However, there was a lot of overlap in the distributions of β-hCG between the two groups. Conclusions In this study, we found lower sensitivity of detecting hydatidiform mole by ultrasound in missed abortion. β-hCG level was higher in hydatidiform mole than in non- hydatidiform mole in missed abortion. Although higher sensitivity of detecting hydatidiform mole is seen by naked eye (60%), in order to minimise missed opportunity of detecting hydatidiform mole, our study suggests that routine histopathological examination is necessary in missed abortion.

scholarly journals Expression of p57 immunomarker in the classification and differential diagnosis of partial and complete hydatidiform moles

2019 ◽  
Vol 11 (03) ◽  
pp. 270-274
Author(s):  
Santosh Kumar Mondal ◽  
Saikat Mandal ◽  
Saptarshi Bhattacharya ◽  
Utpal Kumar Panda ◽  
Arpan Ray ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Single Case ◽  
Hydatidiform Mole ◽  
Prior History ◽  
Nulliparous Women ◽  
Complete Mole ◽  
Beta Human Chorionic Gonadotropin ◽  
Increased Risk ◽  
History Of ◽  
Invasive Mole

Abstract BACKGROUND: Hydatidiform mole (HM) is characterized histologically by cystic swelling of the chorionic villi, accompanied by variable trophoblastic proliferation. The most important reason for the correct recognition of moles is that they are associated with an increased risk of persistent trophoblastic disease (invasive mole) or choriocarcinoma. AIMS AND OBJECTIVES: The aim of the study was to determine whether there is any role of p57 in differentiating partial and complete moles by immunohistochemical staining. MATERIALS AND METHODS: A prospective observational study was undertaken in which 40 cases of molar pregnancy included over a period of 2 years. Detailed clinical and family histories were obtained from each patient. Histopathological examination followed by immunohistochemical study with p57 done in each case. Ultrasonography findings and serial titers of serum beta-human chorionic gonadotropin were noted whenever necessary. RESULTS: Among the forty cases included, 25 (62%) had complete molar (CM) pregnancy, whereas the rest 15 (38%) had partial mole (PM). Both CM and PM were more pronounced in the age group of 20–25 years (44% and 60%, respectively), and among nulliparous women (68% and 70% respectively), 17 (42.5%) mothers had a prior history of abortion. In the histologically unequivocal cases of complete mole, 96% (24 of 25) did not express p57 and a single case was focal positive. In contrast, it was strongly and continuously expressed in both villous cytotrophoblast and stromal cells in all cases of PM (15 of 15). CONCLUSION: p57 immunomarker is very helpful to diagnose and differentiate complete and partial HM.

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