scholarly journals Live second trimester intrauterine pregnancy with invasive mole: a rare case report

2018 ◽  
Vol 7 (4) ◽  
pp. 1657 ◽  
Author(s):  
Muskaan Chhabra ◽  
Rekha Daver
Keyword(s):  
Malignant Transformation ◽  
Gestational Age ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Rare Case Report ◽  
Invasive Mole ◽  
Live Fetus

Gestational trophoblastic disease or gestational trophoblastic neoplasia is a collective term used to describe hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumours. Since any molar pregnancy has the potential to develop into invasive mole these patients should be carefully monitored for development of malignant disease. Here we are reporting a case of invasive molar pregnancy with a single live fetus of 17 weeks gestational age. A 24 years old woman, G3P2L2 with a history of amenorrhea since approximately 5 months presented with profuse per vaginal bleeding. Ultrasound showed presence of live fetus of approximate gestational age of 17 weeks. Along with the fetus there was also presence of cystic areas with no vascularity s/o Hydatiform mole. In view of continued bleeding and severe anemia pregnancy was terminated and fetus along with vesicular tissue was expelled. On follow up Beta hcg titers showed increasing trend over the next week. Repeat USG showed extension of molar tissue into the myometrium. In view of this she was given 3 cycles of chemotherapy and eventually was discharged. She was followed up regularly with no e/o recurrence. Presence of viable fetus along with hydatiform mole is a rare occurrence in obstetric practice. After termination of pregnancy these patients should undergo follow up ultrasound and serial beta HCG titers to detect the malignant transformation. Rising beta HCG titers and invasion of myometrium on ultrasound are the ominous features suggesting malignant transformation and should be treated accordingly.

scholarly journals Twin pregnancy with complete hydatiform mole and coexisting live fetus: A rare case report

2019 ◽  
pp. 31-34
Author(s):  
Swati Agrawal ◽  
Kiran Aggarwal ◽  
Anjali Singh ◽  
Khushbu Saha ◽  
Amrita Mishra ◽  
...  
Keyword(s):  
Rare Case ◽  
Twin Pregnancy ◽  
Gestational Trophoblastic Disease ◽  
Rare Entity ◽  
Trophoblastic Disease ◽  
Complete Mole ◽  
Beta Hcg ◽  
Rare Case Report ◽  
Live Fetus

Twin pregnancy with one live fetus and one complete mole, also known as CMCF i.e. complete molar pregnancy with coexisting live fetus is a rare entity in obstetrics. This combination is associated with increased incidences of spontaneous abortions, vaginal bleeding, prematurity, intrauterine demise, pre-eclampsia, uterine ruptures, theca lutein cysts, persistent gestational trophoblastic disease. We report a rare case of a 24-year-old patient with CMCF at 14 weeks of gestation. After confirming the diagnosis, ruling out malignancy and proper counselling, decision was taken to continue her pregnancy. However, the patient had spontaneous abortion at 15 weeks of gestation. Her serum beta Hcg has shown a decreasing trend in her follow up visits with no signs suggestive of persistent gestational trophoblastic disease.

Gestational trophoblastic disease in Nepalese women managed in B. P. Koirala Memorial Cancer Hospital

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16570-e16570
Author(s):  
J. Pariyar
Keyword(s):  
Brain Metastasis ◽  
Ethnic Group ◽  
Gestational Trophoblastic Disease ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Trophoblastic Disease ◽  
Cancer Hospital ◽  
Invasive Mole ◽  
Disseminated Disease

e16570 Background: Gestational trophoblastic disease (GTD) is potentially curable disease. Its incidence varies in different countries with high incidence reported in Japan (2/1000 pregnancies) and Mexico (2.5/1000 pregnancies). No studies have been reported regarding epidemiology, management and outcome of GTD in Nepal. Methods: The study was a descriptive case series. Case records of GTD patients attending B.P. Koirala Memorial Cancer Hospital, Nepal from 2001 to 2007 were analyzed. The main outcomes were measured in terms of duration, antecedent pregnancy, investigations, treatment and follow-up. Results: A total of 45 cases of gestational trophoblastic disease (GTD) were received from 26 districts of Nepal. The age of the patients ranged from 16 to 50 years with a mean age of 29.1 years (SD 9.4 years). Out of 45 cases 19 (43%) were of Tibeto-Burmese ethnic group and 15 (33%) belonged to Indo-Aryan ethnic group. There were 17 cases (37.8%) of hydatidiform mole, 6 were invasive mole (13.35%), 4 of persistent gestational trophoblastic tumour (8.8%) and 22 patients (48.8%) of choriocarcinoma. In 7 cases (15.5%) molar pregnancy had occurred in the first conception, another 7 cases (15.5%) had previous molar pregnancy and in 16 (35.5%) cases GTD had occurred following abortion. The most common presenting symptom was vaginal bleeding and 26 (57.8%) patients had anaemia. Theca Leuteal cyst was present in 11 (24.5%), 17 (37.8%) cases had lung metastasis, 4 (8.9%) had brain metastasis and another 4 (8.9%) had disseminated disease detecteted radiologically. Among the 45 cases 6 (13.3%) were treated with suction evacuation only; 9 (20%) underwent hysterectomy for uterine perforation, excessive hemorrhage and invasive mole. 28 (62.2%) cases underwent adjuvant chemotherapy among which 12 (26.6%) received single agent chemotherapy and 15 (33.3%) received EMA-CO regimen. Brain irradiation was required in a case with brain metastasis. Five (11.1%) cases with disseminated disease and high WHO risk score left the hospital against medical advice. There were 3 (6.7%) mortalities. 37 (82.1%) cases are in remission and follow-up. Conclusions: Early diagnosis of disease and proper management strongly influences the outcome of GTD. Even in disseminated state GTD can be cured. No significant financial relationships to disclose.

scholarly journals MOLAR ECTOPIC PREGNANCY;

2013 ◽  
Vol 20 (04) ◽  
pp. 638-641
Author(s):  
SHAMA CHAUDHARY ◽  
IQRA JANGDA ◽  
RUBINA HUSSAIN
Keyword(s):  
Ectopic Pregnancy ◽  
Iliac Fossa ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Trophoblastic Disease ◽  
Beta Hcg ◽  
History Of ◽  
The Right

Ectopic molar pregnancy is a rare occurrence. Clinical diagnosis of a molar pregnancy is difficult but histopathology is thegold standard for diagnosis. The management of ectopic molar pregnancies consists of surgically removing the conceptus, follow up &chemotherapy, if required. We are reporting a case report of a 35-year-old married, nulliparous woman, admitted in emergency with a 6-week history of amenorrhea, severe abdominal pain & an episode of fainting at home. Per abdominal examination revealed tendernessover the right iliac fossa, with guarding & rigidity. Diagnosis of ruptured ectopic pregnancy was made.Emergency laparotomy was done.Histopathological examination, showed tubal ectopic pregnancy with partial hydatidiform mole & a separate corpus luteal cyst.She wasfollowed up with serial beta hCG which became normal within 1 month. Although ectopic molar pregnancy is a rare entity but all ectopicpregnancies should be examined histologically to rule out presence of gestational trophoblastic disease to plan follow-up accordingly inorder to avoid persistent gestational trophoblastic disease which has a chance of malignant conversion.The prognosis of ectopic molarpregnancies is the same as for other forms of gestational trophoblastic disease.

scholarly journals Partial Mole Coexistence with a Normal Live Fetus in Twin Pregnancy

2019 ◽  
Vol 60 (4) ◽  
pp. 234-237
Author(s):  
Saabh I. Alkateeb ◽  
Hala M. Alkhalidy
Keyword(s):  
Gestational Age ◽  
Twin Pregnancy ◽  
The Other ◽  
Normal Vaginal Delivery ◽  
Close Monitoring ◽  
Uterine Contractions ◽  
Invasive Mole ◽  
Live Fetus ◽  
Normal Placenta

We present a case of dizygotic diamiontic twin pregnancy in which one fetus was normal with normal placenta, the 2nd fetus was normal appearing with partial molar placenta. All required investigation and clinical assessments were carried out and revealing partial molar pregnancy in one fetus and normal placenta of the other one. Maternal BhCG was high for  gestational age.The patient was a 31-year-old presented to Central Private Hospital; her gestational age was 22 weeks +5 days following IVF (after 10 years of primary infertility) of diazygotic diamiontic twin pregnancy as a case of vaginal bleeding from 8 weeks of gestation with uterine contractions. The patient had gestational DM & hyperthyroidism. Appropriate treatment regarding her conditions was implemented All appropriate management was implemented. The patient continued to bleed. Within few days of admission she had premature uncomplicated labor with normal vaginal delivery (gestational age was23 Wks +3 days), both babies appeared normal, one placenta morphologically &histologically typical of H.mole. The other one completely was normal. Monitoring of serum BhCG and follow up transvaginal US was done until BhCG level returned to normal after 3 months of delivery without chemotherapy. Close monitoring of pregnancy from early stages and discussing the possible complications to mother and baby (such as baby may be chromosomally abnormal &may not survive) with parents is important to manage such complications. It is also necessary to have post-natal close follow up for maternal BhCG levels to assess any possibility of invasive mole or choriocarcinoma.

scholarly journals Patient profile of gestational trophoblastic disease at Patan Hospital, Nepal

2015 ◽  
Vol 2 (1) ◽  
pp. 3-6
Author(s):  
Alka Singh ◽  
Reena Shrestha
Keyword(s):  
Gestational Age ◽  
Vaginal Bleeding ◽  
Gestational Trophoblastic Disease ◽  
Cross Sectional Study ◽  
Molar Pregnancy ◽  
Cross Sectional ◽  
Gonadotropin Level ◽  
Patient Profile ◽  
Trophoblastic Disease ◽  
Invasive Mole

Introductions: This study was designed to determine the demographic pattern, incidence, clinical features and management outcome of gestational trophoblastic disease (GTD) in Patan Hospital.Methods: This was a cross sectional study conducted at Patan Hospital from April 13, 2008 to April 12, 2013. Medical record of cases diagnosed as GTD were retrieved from the record section for review. The age, parity, estimated gestational age at the time of evacuation, presence or absence of vaginal bleeding, uterine size in relation to gestational age, ultrasonogram report and urinary beta human chorionic gonadotropin level, histopathology findings, modalities of treatment and outcomes were analyzed.Results: There was total of 41,543 deliveries during five years study period and 54 GTD on histopathology. Among the 54 GTDs, 40 (74%) were molar pregnancy, 8 (14.4%) invasive mole and 6 (11%) choriocarcinoma. The frequency of GTD was 1 per 769 pregnancies. The age of the women with GTD ranged from 15-50 years. Half of the cases were below 25 years. Most of the women presented between 8-12 weeks of gestation and below third gravida. Amenorrhea with vaginal bleeding was seen in 49 (90%) patients.Conclusions: The most common GTD observed in this study was molar pregnancy. Vaginal bleeding was the common complaints at presentation.Journal of Patan Academy of Health Sciences, Vol. 2, No. 1, 2015. page: 3-6

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

CHOREA GRAVIDARUM: A RARE CASE REPORT

2021 ◽  
pp. 71-72
Author(s):  
Aswini Viswanadh ◽  
Sujata Singh ◽  
Vinnisa N. V
Keyword(s):  
Case Report ◽  
Family History ◽  
Gestational Age ◽  
Postpartum Period ◽  
Rare Case ◽  
Third Trimester ◽  
Detailed Evaluation ◽  
Rare Case Report

Chorea gravidarum is the term given to chorea occurring during pregnancy. Here, we report a case of 24 year old primigravida at gestational age 38 weeks 3days ,without any signicant past & family history who presented with chorea gravidarum for the rst time in third trimester. On detailed evaluation no etiology was identied. On follow up in postpartum period, her choreiform movements have reduced in intensity, but is still persisting pointing towards an idiopathic origin.

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

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.

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