scholarly journals Early diagnosis and treatment of hydatidiform mole in adolescent pregnant woman

2021 ◽  
Vol 9 (6) ◽  
pp. 1760
Author(s):  
Putu Harrista Indra Pramana ◽  
Kaspan Kaspan
Keyword(s):  
Ultrasound Imaging ◽  
Complete Blood Count ◽  
Hydatidiform Mole ◽  
Good Condition ◽  
Stable State ◽  
Placental Tissue ◽  
Tissue Formation ◽  
Clinical Appearance ◽  
Elementary School Education ◽  
Normochromic Anemia

Hydatidiform mole belongs to the spectrum of gestational trophoblastic disorders in which abnormal conception leads to excess placental tissue formation in the absence of fetal development. The incidence of hydatidiform mole is quite rare so that not all experienced clinicians handle this case in clinical experience. Therefore, we present a case of hydatidiform mole in an adolescent patient. A 14-year-old primigravida woman, unemployed, with elementary school education, with a gestational age of 16 weeks went to the ER with complaints of vaginal bleeding for 2 days. Physical examination found the fundal height at umbilicus, abdominal tenderness, accompanied by vaginal bloody discharge. Complete blood count found mild normochromic anemia with increased levels of T3 and decreased TSH. Ultrasound imaging found a typical vesicular pattern of a hydatidiform mole. Treatment of molar evacuation by curettage and drainage was carried out one day after presentation and obtained 600 grams of molar tissue. The patient underwent 24 hours of post-operative observation before being discharged in a stable state. The patient presented with a typical clinical appearance of hydatidiform mole. Ultrasound imaging reveals a typical complete hydatidiform mole accompanied by anemia and hyperthyroxinemic which may accompany hydatidiform mole. Evacuation was carried out according to clinical guidelines and the patient was discharged in a good condition.

scholarly journals Variants in Maternal Effect Genes and Relaxed Imprinting Control in a Special Placental Mesenchymal Dysplasia Case with Mild Trophoblast Hyperplasia

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 544
Author(s):  
Tien-Chi Huang ◽  
Kung-Chao Chang ◽  
Jen-Yun Chang ◽  
Yi-Shan Tsai ◽  
Yao-Jong Yang ◽  
...  
Keyword(s):  
Maternal Effect ◽  
Hydatidiform Mole ◽  
Placental Tissue ◽  
Differentially Methylated Region ◽  
Normal Birth ◽  
Maternal Effect Genes ◽  
Common Etiology ◽  
Artificial Abortion ◽  
Secondary Dmr ◽  
Placental Mesenchymal Dysplasia

Placental mesenchymal dysplasia (PMD) and partial hydatidiform mole (PHM) placentas share similar characteristics, such as placental overgrowth and grape-like placental tissues. Distinguishing PMD from PHM is critical because the former can result in normal birth, while the latter diagnosis will lead to artificial abortion. Aneuploidy and altered dosage of imprinted gene expression are implicated in the pathogenesis of PHM and also some of the PMD cases. Diandric triploidy is the main cause of PHM, whereas mosaic diploid androgenetic cells in the placental tissue have been associated with the formation of PMD. Here, we report a very special PMD case also presenting with trophoblast hyperplasia phenotype, which is a hallmark of PHM. This PMD placenta has a normal biparental diploid karyotype and is functionally sufficient to support normal fetal growth. We took advantage of this unique case to further dissected the potential common etiology between these two diseases. We show that the differentially methylated region (DMR) at NESP55, a secondary DMR residing in the GNAS locus, is significantly hypermethylated in the PMD placenta. Furthermore, we found heterozygous mutations in NLRP2 and homozygous variants in NLRP7 in the mother’s genome. NLRP2 and NLRP7 are known maternal effect genes, and their mutation in pregnant females affects fetal development. The variants/mutations in both genes have been associated with imprinting defects in mole formation and potentially contributed to the mild abnormal imprinting observed in this case. Finally, we identified heterozygous mutations in the X-linked ATRX gene, a known maternal–zygotic imprinting regulator in the patient. Overall, our study demonstrates that PMD and PHM may share overlapping etiologies with the defective/relaxed dosage control of imprinted genes, representing two extreme ends of a spectrum.

Early diagnosis of hydatidiform mole by ultrasound imaging

JAMA ◽  
1973 ◽  
Vol 225 (11) ◽  
pp. 1359-1360 ◽  
Author(s):  
J. C. Birnholz
Keyword(s):  
Early Diagnosis ◽  
Ultrasound Imaging ◽  
Hydatidiform Mole

scholarly journals Ultrasound Imaging of Postpartum Hemorrhage

2015 ◽  
Vol 9 (2) ◽  
pp. 175-187 ◽  
Author(s):  
Wiku Andonotopo ◽  
Prachi Kasar
Keyword(s):  
Ultrasound Imaging ◽  
Postpartum Hemorrhage ◽  
Early Stage ◽  
Color Doppler ◽  
Placental Tissue ◽  
3D Ultrasound ◽  
Diagnosis And Treatment ◽  
Postpartum Bleeding ◽  
Lower Genital Tract

ABSTRACT The etiology of postpartum hemorrhage (PPH) is diverse and management depends on identifying the cause and tailoring treatment appropriately. The major causes of PPH are uterine atony, endometritis, retained placental tissue, placental abnormalities, i.e. placenta accreta, increta and percreta, subinvolution of the placental implantation site, arteriovenous malformation (AVM), lower genital tract trauma, uterine abnormalities, bleeding disorders, coagulopathies and use of anticoagulants. Use of imaging modalities (i.e. ultrasound scanning and color and pulsed Doppler) at an early stage in the search for the etiology of PPH helps to decrease morbidity and mortality. This article reviews the differential diagnoses for bleeding in the postpartum period and assesses the role of ultrasound in the diagnosis and treatment of postpartum bleeding. By using illustrative images, the reader will be able to correlate findings on B-mode, color Doppler and 3D ultrasound in diagnosis and treatment of postpartum bleeding. It is important to be aware of the appearance of normal postpartum uterus to avoid misdiagnosis. How to cite this article Kasar P, Andonotopo W, Kupesic Plavsic S. Ultrasound Imaging of Postpartum Hemorrhage. Donald School J Ultrasound Obstet Gynecol 2015;9(2):175-187.

scholarly journals Molar Changes with a Normal Viable Fetus: A Case Report

2020 ◽  
Author(s):  
Marjaneh Farazestanian ◽  
Asieh Maleki ◽  
Somayeh Bolandi ◽  
Zohreh Yousefi ◽  
Malihe Hasanzadeh ◽  
...  
Keyword(s):  
Case Report ◽  
Hydatidiform Mole ◽  
Good Condition ◽  
Significant Risk ◽  
Rare Condition ◽  
Normal Karyotype ◽  
Elective Cesarean Section ◽  
Close Monitoring ◽  
Singleton Pregnancy ◽  
Normal Fetus

Objective: The presence of a normal fetus with normal karyotype accompanied by molar changes in the placenta is a rare condition, which carries a significant risk to the mother and fetus. There is a controversy regarding the proper management of this condition. Here, we present the case of a singleton pregnancy that showed molar changes in the pathological study of the placenta, but ended up with a normal viable neonate. Case Report: A 23-year-old primigravida woman, with a 3-year history of infertility, presented with vaginal bleeding and spotting. Her ß-human chorionic gonadotropin (HCG) at 13th week was 36500 mIU/ml. Serial sonography assessments were suggestive for molar changes and a normal fetus with growth retardation but normal Doppler assessment. The patient underwent elective Cesarean section at 37 weeks gestation and a healthy female neonate with an Apgar score of 9-10, weighing 2270 g was born. Pathological assessment of the placenta confirmed the diagnosis of incomplete hydatidiform mole. After two months, the mother had no complications, her ß-HCG level was untraceable, and the infant was in good condition. Conclusion: Despite being a rare condition, partial moles can be accompanied by delivery of a normal fetus. The management of this condition still remains challenging and should be done under close monitoring with extreme caution.

scholarly journals Hemogram abnormalities in apparently healthy first-time blood donors in Libreville, Gabon.

2019 ◽  
Author(s):  
Cyrille BISSEYE ◽  
Jophrette Mireille Ntsame Ndong ◽  
Landry Erik Mombo ◽  
Hornéla Christine Minkoue Mambéri ◽  
Guy Mouelet Migolet ◽  
...  
Keyword(s):  
Blood Donors ◽  
Blood Donation ◽  
Complete Blood Count ◽  
Selection Process ◽  
Hypochromic Anemia ◽  
Transfusion Center ◽  
Blood Transfusion Center ◽  
Normochromic Anemia ◽  
First Time ◽  
Apparently Healthy

Background: The objective of this study was to determine complete blood count (CBC) abnormalities in Libreville blood donors to advocate for hemoglobin pre-donation implementation and to take into account CBC results in blood donation qualification. Methods: This retrospective study was conducted with 4573 blood donors in March 2016 and from January to April 2017. CBC was performed using SysmexXP-300TM hematology analyzer (SYSMEX Corporation, Kobe, Japan). Results: Blood donors were predominantly males (83.7%) with an age ranging from 18 to 59 years. The abnormalities of leukocyte, platelet and erythrocyte counts were determined in blood donors. Leukopenia and thrombocytopenia were significantly more common in men than women (29.02% vs 24.4%, p = 0.011 and 16.2% vs 7.5%, p <0.001). Only 1.0% of women and 0.84% of men have leukocytosis, and 0.7% of women and 0.2% of men have thrombocytosis. Anemia was significantly more common in women compared to men (69.4% vs. 45.0%, P <0.001). Normocytic normochromic and normocytic hypochromic anemia were most common among Libreville blood donors with 39.4% and 23.6%; followed by microcytic normochromic (18.7%) and microcytic hypochromic (13.2%) anemia. Normocytic normochromic and normocytic hypochromic anemia were significantly more common in men than in women, whereas microcytic normochromic anemia was more prevalent among women compared to men (34.6% vs. 13.9%, p <0.001). Conclusions: The results of this study clearly show the need to perform a pre-donation hemoglobin test in blood donors and to take into account their hemogram in the blood donation selection process at the Libreville National Blood Transfusion Center. Keywords: Hemogram, Anemia, Blood Donors, Libreville, Gabon.

scholarly journals Fibrinolytic Activity of Hydatidiform Molar Tissue

1977 ◽  
Author(s):  
F. H. M. Tsakok ◽  
S. S. Ratnam
Keyword(s):  
Fibrinolytic Activity ◽  
Hydatidiform Mole ◽  
Placental Tissue ◽  
Uterine Bleeding ◽  
Fibrinolytic System ◽  
Coagulation System ◽  
Molar Pregnancy ◽  
Plate Method ◽  
Fibrin Plate ◽  
Normal Placenta

Intravascular coagulation has been previously suspected in hydatidiform molar pregnancy (McKay 1965) and isolated cases have been described (Egley 1974). Recently a comprehensive coagulation profile in 18 intact hydatidiform molar pregnancies has been reported (Tsakok 1976). These studies showed evidence of abnormal proteolysis with activation of the coagulation system and the fibrinolytic system in varying degrees. In the present work the fibrinolytic activity of fresh molar tissue from 16 patients was studied by the fibrin plate method (Nilsson 1962) and by histochemistry (Pandolfi 1972). The fibrinolytic activity was compared with fresh normal placental tissue.Marked fibrinolytic activity was found in the hydatidiform molar tissue as compared to none in the normal placenta. Increased fibrinolytic activity of hydatidiform mole may be the cause of early, prolonged and heavy uterine bleeding in such abnormal pregnancies. This may be due to local activation of the fibrinolytic system.

scholarly journals LINE-1 Methylation Patterns as a Predictor of Postmolar Gestational Trophoblastic Neoplasia

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ruangsak Lertkhachonsuk ◽  
Krissada Paiwattananupant ◽  
Patou Tantbirojn ◽  
Prakasit Rattanatanyong ◽  
Apiwat Mutirangura
Keyword(s):  
Hydatidiform Mole ◽  
First Trimester ◽  
Methylation Pattern ◽  
Gestational Trophoblastic Neoplasia ◽  
Partial Methylation ◽  
Clinical Appearance ◽  
Malignant Trophoblast ◽  
Sensitivity Specificity ◽  
Methylation Patterns ◽  
Hydatidiform Moles

Objective. To study the potential of long interspersed element-1 (LINE-1) methylation change in the prediction of postmolar gestational trophoblastic neoplasia (GTN).Methods. The LINE-1 methylation pattern from first trimester placenta, hydatidiform mole, and malignant trophoblast specimens were compared. Then, hydatidiform mole patients from 11999 to 2010 were classified into the following 2 groups: a remission group and a group that developed postmolar GTN. Specimens were prepared for a methylation study. The methylation levels and percentages of LINE-1 loci were evaluated for their sensitivity, specificity, and accuracy for the prediction of postmolar GTN.Results. First, 12 placentas, 38 moles, and 19 malignant trophoblast specimens were compared. The hydatidiform mole group had the highest LINE-1 methylation level (p= 0.003) and theuCuC of LINE-1 increased in the malignant trophoblast group (p≤ 0.001). One hundred forty-five hydatidiform mole patients were classified as 103 remission and 42 postmolar GTN patients. The %mCuC and %uCmC of LINE-1 showed the lowestpvalue for distinguishing between the two groups (p< 0.001). The combination of the pretreatmentβ-hCG level (≥100,000 mIU/mL) with the %mCuC and %uCmC, sensitivity, specificity, PPV, NPV, and accuracy modified the levels to 60.0%, 92.2%, 77.4%, 83.8%, and 82.3%, respectively.Conclusions. A reduction in the partial methylation of LINE-1 occurs early before the clinical appearance of malignant transformation. The %mCuC and %uCmC of LINE-1s may be promising markers for monitoring hydatidiform moles before progression to GTN.

Clinical utility of selective molecular genotyping for diagnosis of partial hydatidiform mole; a retrospective study from a regional trophoblastic disease unit

2014 ◽  
Vol 67 (11) ◽  
pp. 980-984 ◽  
Author(s):  
Rosemary A Fisher ◽  
Anna Tommasi ◽  
Dee Short ◽  
Baljeet Kaur ◽  
Michael J Seckl ◽  
...  
Keyword(s):  
Tandem Repeats ◽  
Hydatidiform Mole ◽  
Placental Tissue ◽  
Management Approach ◽  
Parental Origin ◽  
Definite Diagnosis ◽  
Maternal Tissue ◽  
Molecular Genotyping ◽  
Increased Risk ◽  
Technical Issues

AimsHydatidiform moles (HMs) are genetically abnormal conceptions, associated with increased risk of gestational trophoblastic neoplasia. Diagnosis is usually based on histopathological criteria but in a minority definitive histological diagnosis is not possible; in such cases molecular genotyping may be diagnostic. This study describes the clinical usefulness of such an approach.MethodsCases in which central histology review demonstrated abnormal villous morphological features insufficient for definite diagnosis of partial HM (PHM) (‘favour PHM’ or ‘PHM not excluded’) underwent molecular genotyping of villous and maternal tissue, using short tandem repeats, to determine ploidy and parental origin of the placental tissue.ResultsOf 251 cases with non-diagnostic morphological villous abnormalities, molecular investigation was not possible in 14 (6%; limited material or technical issues). Overall, 124 (49%) were triploid including 71/86 (85%) of those morphologically favouring PHM, and 53/165 (32%) of those favouring non-molar miscarriage. Of 85 cases of triploidy in whom sufficient material was available, 84 had an additional paternal contribution. Single cases of digynic triploidy, tetraploid PHM and two mosaic conceptions were also identified. Twenty-three non-molar diploid cases (21%) exhibited trisomy.ConclusionsMolecular genotyping allows definitive diagnosis of PHM for cases in which specialist histopathology review remains equivocal. While this approach provides definite diagnosis it is considerably more expensive than a pragmatic management approach of human chorionic gonadotrophin surveillance in all such cases.

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