COMORBIDADES ASSOCIADAS A MOLA HIDATIFORME: COMO DIAGNOSTICAR E TRATAR

2018 ◽  
Vol 5 (3) ◽  
pp. 68-74
Author(s):  
Isabela Borges Corrêa ◽  
Mariana Rocha Machado de Carvalho ◽  
Nayara Pettine Dias Soares ◽  
Hanna Helena Lopes ◽  
Luciana Zenóbio Quadra Vieira dos Santos
Keyword(s):  
Early Diagnosis ◽  
Hydatidiform Mole ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Diagnosis And Treatment ◽  
Uterine Perforation ◽  
Vacuum Aspiration ◽  
De Se ◽  
Aspiration Technique ◽  
Life Threatening

RESUMO A mola hidatiforme é uma forma benigna da doença trofoblástica gestacional pouco frequente na gravidez e com potencial para evoluir para formas que necessitam de tratamento sistêmico e podem ameaçar a vida. As apresentações com molas de grande volume, com eliminação de vesículas e anemia, são cada vez menos frequentes devido ao uso sistemático de ultrassonografia gestacional no primeiro trimestre de gestação que permite o diagnóstico precoce. Ainda assim, raramente podem ocorrer certas complicações, como hemorragia, hipertireoidismo, pré-eclâmpsia, insuficiência respiratória e cistos ovarianos, que exigem conduta imediata e encaminhamento das pacientes para centro de referências que realizem aspiração uterina, preferencialmente, pela técnica de vácuo-aspiração, a fim de se evitar possíveis intercorrências, dentre as quais a perfuração uterina. Deve ser realizado seguimento rigoroso, sistemático e pontual para diagnóstico precoce de NTG e preservação da fertilidade das mulheres acometidas. Enfatizar os métodos de diagnóstico e tratamento das principais comorbidades associadas a mola hidatiforme é o objetivo deste estudo, que foi realizado através de uma revisão de literatura , utilizando artigos dos últimos 15 anos, nacionais e internacionais arquivados nos bancos de dados MEDLINE, BIREME, PUBMED, SciELO e Livros periódicos analisados nas biblioteca do Instituto Presidente Antônio Carlos.   Palavras-chave: Comorbidades associadas a gravidez molar. Mola hidatiforme – diagnóstico e tratamento. Neoplasia trofoblástica gestacional. ABSTRACT A hydatidiform mole is a benign form of infrequent gestational trophoblastic disease in pregnancy and it has the potential to evolve into forms that require systemic treatment and can be life-threatening. Presentations with large amounts of moles, with elimination of vesicles and anemia, are becoming less frequent due to the systematic use of gestational ultrasound in the first trimester of pregnancy that allows early diagnosis. Still, it could rarely occur certain complications, such as bleeding, hyperthyroidism, preeclampsia, respiratory failure and ovarian cysts, requiring immediate management and referral to the center of reference to perform a uterine aspiration, preferably by vacuum aspiration technique, in order to avoid possible complications, among them uterine perforation. It should be rigorous systematic and timely followed, for early diagnosis of NTG and preservation of affected women’s fertility. This paper aims to emphasize the methods of diagnosis and treatment of major comorbidities associated with hydatidiform mole. This course conclusion work was done through a literature review, using articles from the last 15 years, national and international, using the databases MEDLINE, BIREME, PUBMED, SciELO and periodicals Books analyzed in the library of the Instituto Presidente Antonio Carlos. Keywords: Comorbidities associated with molar pregnancy. Hydatidiform mole - Diagnosis and Treatment. Neoplasia gestational trophoblastic.

scholarly journals Traumatic Diaphragmatic Hernia: Management and Review

2021 ◽  
pp. 1-3
Author(s):  
Sweety kumari ◽  
Keyword(s):  
Early Diagnosis ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Diagnosis And Treatment ◽  
Therapeutic Tool ◽  
Penetrating Injuries ◽  
Traumatic Diaphragmatic Hernia ◽  
Delay In Diagnosis ◽  
Life Threatening ◽  
Suspicion Index

Traumatic diaphragmatic injury (TDI) is a fairly uncommon with incidence of 0.8 and 1.6 %, commonest fallowing blunt trauma abdomen. Right-side have higher mortality rate compared to left side and penetrating injuries. It present as occult to obvious. Laparoscopy offers diagnostic and therapeutic tool of care. Lack of awareness of the condition may delay in diagnosis, results life threatening complications. Missed hernia is a known complication of blunt trauma as acute diagnosis can be difficult to ascertain. An early diagnosis and treatment lead to better outcome. In present study CECT revealed acute diaphragmatic hernia, bilateral pleural effusion and hair line fracture of right tibia on skiagram limb. Because of uncertainty in diagnosis of acute diaphragmatic hernia or rupture surgeons faces challenges for the management, high suspicion index required to diagnose the cases. An early diagnosis and treatment lead to better outcome

scholarly journals Congenital Dermal Sinus: case series and the consequences of late diagnosis and treatment

2020 ◽  
Vol 2 (3(September-December)) ◽  
pp. e622020
Author(s):  
Alick Durão Moreira ◽  
Antonio Bellas ◽  
Marcelo Sampaio Poousa ◽  
Rafaeldos Santos Mitraud Mitraud ◽  
Tatiana Protzenko
Keyword(s):  
Early Diagnosis ◽  
Clinical Presentation ◽  
Focal Point ◽  
Case Series ◽  
Diagnosis And Treatment ◽  
Definitive Treatment ◽  
Dermal Sinus ◽  
Lumbar Region ◽  
Image Study ◽  
Life Threatening

Introduction:Congenital Dermal Sinuses (CDS) are rare closed dysraphisms that can present throughout the extent of the neuroaxis. They occur due to a failure of the disjunction of the neuroectoderm and cutaneous ectoderm in a focal point during 3-4 week of embryogenic development. The prevalence of CDS of all types has been estimated to be 1 in 2,500 live births, most commonly localized in the lumbar region. More than half of the cases are associated with dermoid or epidermoid tumors. Clinical presentation of CDS usually consists in cutaneous stigmas like dimples, which has the potential to be diagnosed at birth. However, the majority of patients are diagnosed older and after complications such as meningitis, abscess, osteomyelitis, rupture of an associated epi/dermoid cyst. Once suspected the patient should be submitted to an image study with CT scan and/or MRI, and surgical consultation. Complete exeresis is the definitive treatment. Case report: we present 3 cases of CDS, including an extremely rare case of frontonasal location, to illustrate the extent of the disease and the importance of early diagnosis and treatment. All of the 3 cases presented with complications, requiring surgical treatment and long term antibiotic therapy. Conclusion: Although well reported in the literature, CDS are usually diagnosed after complications. The knowledge of clinical presentation, early diagnosis and treatment are essential to prevent its life threatening complications. 

Management of a complete hydatidiform mole with a coexisting live fetus followed by successful treatment of maternal metastatic gestational trophoblastic disease: learning points

2021 ◽  
Vol 14 (1) ◽  
pp. e235028
Author(s):  
Zhun Wei Mok ◽  
Khurshid Merchant ◽  
Swee Lin Yip
Keyword(s):  
Hydatidiform Mole ◽  
Single Agent ◽  
Pulmonary Nodules ◽  
Breech Presentation ◽  
Male Infant ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Intrauterine Pregnancy ◽  
Trophoblastic Disease ◽  
Unexpected Findings

A 34-year-old patient had her first trimester Down syndrome scan followed by serial ultrasound scans which showed a single intrauterine pregnancy with multiple cystic areas in the anterior placenta. She presented in preterm labour with a breech presentation at 32 weeks and underwent an emergency caesarean section. She delivered a male infant weighing 1750 g. The placental histopathology showed a complete hyatidiform mole. At 4 weeks postpartum, beta-human chorionic gonadotrophin (Bhcg) levels rose from 460 to 836 mIU/mL over 1 week. Metastatic workup revealed prominent pelvic nodes and pulmonary nodules in both lungs. This was discussed at the Multi-Disciplinary Tumour Board and single-agent intramuscular methotrexate was recommended. After chemotherapy, she achieved Bhcg normalisation after three cycles. This case highlights the importance of clinical vigilance even in low-risk patients. Unexpected findings on ultrasound should involve multidisciplinary input with radiology colleagues. A high index of suspicion for gestational trophoblastic disease and close follow-up is imperative.

scholarly journals Complex Congenital Heart Disease in an Infant - A Case Report and Review

2021 ◽  
Vol 10 (39) ◽  
pp. 3505-3507
Author(s):  
Srinivas Naik ◽  
Sourya Acharya ◽  
Gajendra Agrawal ◽  
Chetan Rathi ◽  
Sunil Kumar
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Diagnosis ◽  
Congenital Heart ◽  
Clinical Presentation ◽  
Heart Diseases ◽  
Diagnosis And Treatment ◽  
Ductus Venosus ◽  
Congenital Heart Diseases ◽  
Life Threatening

Congenital heart disease (CHD) often poses a great diagnostic challenge for physicians. Despite antenatal diagnostic tests advancing to a great level, accurate diagnosis and treatment of congenital heart diseases is mandatory. These diseases range from mild to severe life-threatening scenarios sometimes having vague presentations making diagnosis even more difficult. Early diagnosis and treatment are usually lifesaving.1 Congenital heart diseases can often be classified as cyanotic and acyanotic based on clinical presentation. After birth, fetal structures like foramen ovale, ductus venosus and ductus arteriosus are no longer required for survival and they begin to close.2 Persistence of such structures after birth is a sign of congenital heart diseases. High mortality contributing diseases which require prompt intervention include hypoplastic left heart syndrome (HLHS), coarctation of aorta (COA), interrupted aortic arch (IAA), transposition of the great arteries (TGA), total anomalous pulmonary venous return (TAPVR), critical aortic stenosis (AS) pulmonary atresia (PA) and tricuspid atresia (TA).3 They contribute to significant mortality amongst neonatal age groups. Recognition of congenital heart diseases based on clinical fractures like cyanosis, tachycardia, tachypnoea, irritability, refusal to feed stabilisation and prompt referral to tertiary cardiac centre are critical to improve outcomes in neonates with CHDs, seizures, murmur etc is diagnostically challenging but lifesaving. Life-threatening CHDs may perhaps present with cyanosis, respiratory distress, shock or collapse; all of these are also frequent clinical presentation of various respiratory problems or sepsis in newborn. Early diagnosis and prompt treatment are the only life saving measures.

scholarly journals A Rare Presentation of Cervical Pregnancy

2014 ◽  
Vol 2 (1) ◽  
pp. 40-41
Author(s):  
Seema Hakim ◽  
Shazia Parveen
Keyword(s):  
Early Diagnosis ◽  
South Asian ◽  
Uterine Cavity ◽  
Diagnosis And Treatment ◽  
Rare Presentation ◽  
Cervical Pregnancy ◽  
Threatening Condition ◽  
Life Threatening

ABSTRACT Cervical pregnancy is a pregnancy where implantation occurs in the cervix of uterus rather than occurring in the uterine cavity. It is a rare life-threatening condition so early diagnosis and treatment can save life. Here, we are reporting a case of cervical pregnancy which presented to us with amenorrhea and bleeding per vaginum after misoprostol intake. How to cite this article Parveen S, Hakim S. A Rare Presentation of Cervical Pregnancy. J South Asian Feder Menopause Soc 2014;2(1):40-41.

Changing Trends in the Clinical Presentation and Management of Complete Hydatidiform Mole Among Brazilian Women

2016 ◽  
Vol 26 (5) ◽  
pp. 984-990 ◽  
Author(s):  
Antonio Braga ◽  
Valéria Moraes ◽  
Izildinha Maestá ◽  
Joffre Amim Júnior ◽  
Jorge de Rezende-Filho ◽  
...  
Keyword(s):  
Natural History ◽  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Gestational Trophoblastic Neoplasia ◽  
Complete Hydatidiform Mole ◽  
Trophoblastic Disease ◽  
History Of

ObjectiveThe aim of the study was to evaluate potential changes in the clinical, diagnostic, and therapeutic parameters of complete hydatidiform mole in the last 25 years in Brazil.MethodsA retrospective cohort study was conducted involving the analysis of 2163 medical records of patients diagnosed with complete hydatidiform mole who received treatment at the Rio de Janeiro Reference Center for Gestational Trophoblastic Disease between January 1988 and December 2012. For the statistical analysis of the natural history of the patients with complete molar pregnancies, time series were evaluated using the Cox-Stuart test and adjusted by linear regression models.ResultsA downward linear temporal trend was observed for gestational age of complete hydatidiform mole at diagnosis, which is also reflected in the reduced occurrence of vaginal bleeding, hyperemesis and pre-eclampsia. We also observed an increase in the use of uterine vacuum aspiration to treat molar pregnancy. Although the duration of postmolar follow-up was found to decline, this was not accompanied by any alteration in the time to remission of the disease or its progression to gestational trophoblastic neoplasia.ConclusionsEarly diagnosis of complete hydatidiform mole has altered the natural history of molar pregnancy, especially with a reduction in classical clinical symptoms. However, early diagnosis has not resulted in a reduction in the development of gestational trophoblastic neoplasia, a dilemma that still challenges professionals working with gestational trophoblastic disease.

scholarly journals Varied presentations of gestational trophoblastic disease in Asian women: one year follow up

2016 ◽  
Vol 4 (1) ◽  
pp. 269
Author(s):  
Sumitra Bachani ◽  
Neha Pruthi ◽  
Sana Tiwari ◽  
Pratima Mittal
Keyword(s):  
Hydatidiform Mole ◽  
Tertiary Care ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Good Prognosis ◽  
Care Hospital ◽  
Asian Ethnicity ◽  
Trophoblastic Disease ◽  
One Year

Gestational trohoblastic tumors are rare tumors which constitute less than 1% cancers of female reproductive system. They have varied presentations of which hydatidiform mole is most common. The incidence is higher in Asia and South America as compared to the rest of the world. We present a total of 5 cases of Gestational trophoblastic disease (GTD) constituting 12.2% of admissions in Gynaecology ward of a tertiary care hospital over one year. There are various risk factors which predispose to GTD include maternal age less than 20 years or more than 35 years, prior GTD, prior miscarriages, Asian ethnicity and blood group A. Commonly the woman  presents with vaginal bleeding in first trimester. Sonography and β-hCG are decisive in establishing the diagnosis and further management. Follow up of the patient is very crucial. Early diagnosis and timely management results in good prognosis.

scholarly journals Incidental Finding of Persistent Hydatidiform Mole in an Adolescent on Depo-Provera

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Olukayode Akinlaja ◽  
Rebecca McKendrick ◽  
Zineb Mashak ◽  
May Nokkaew
Keyword(s):  
Vaginal Bleeding ◽  
Incidental Finding ◽  
Hydatidiform Mole ◽  
Signs And Symptoms ◽  
Gestational Trophoblastic Disease ◽  
Positive Pregnancy Test ◽  
Life Threatening ◽  
Depo Provera ◽  
Abnormal Vaginal Bleeding ◽  
High Index Of Suspicion

Molar pregnancies represent an uncommon yet important obstetric problem with potentially fatal outcomes. Patients typically present with signs and symptoms of early pregnancy, and physicians most often suspect nonmolar pregnancy complications initially; however a hydatidiform mole should be included in the differential diagnosis of a woman with a positive pregnancy test and abnormal vaginal bleeding irrespective of the use of contraception. Our case is that of an adolescent female on Depo-Provera injectable contraceptive with increased vaginal bleeding, abdominal pain, nausea, and vomiting who was incidentally found to be pregnant and subsequently diagnosed with a molar pregnancy despite persistent denial of having initiated sexual intercourse. Though gestational trophoblastic disease is uncommon with an incidence of about 1-2 cases per 1,000 pregnancies, a clinician has to display a high index of suspicion when dealing with patients at extremes of age in order to avoid potentially life-threatening outcomes.

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