scholarly journals Partial Hydatidiform Mole with Alive Term IUGR Foetus

2017 ◽  
Vol 34 (3) ◽  
pp. 164-167 ◽  
Author(s):  
Rowshan Ara ◽  
Jahanara Begum ◽  
Setara Binte Kasem ◽  
Shadiqul Hoque ◽  
Shamim Fatema Nargis

Gestational Trophoblastic diseases consist of a broadspectrum of conditions ranging from an uncomplicated partial hydatidiform molar pregnancy to stage -IV choriocarcinoma with cerebral metastasis. Incidence of hydatidiform mole with a co-existing live fetus varies between 0.005 to 0.01 % of all pregnancies. We report a case of partial molar pregnancy with alive term IUGR (intrauterine growth retardation) foetus. Diagnosis was made by sonographic findings of molar changes at her 28 weeks of gestation. Anomaly scan showed no fetal abnormality. At 40 weeks of pregnancy patient went to spontaneous labour and delivered a severely IUGR baby weighing 1.5 kg and it was morphologically normal. There was a single placenta; one third of it was replaced by molar tissue. As the singletone alive pregnancy with partial molar changes is extremely rare occurrence we reported the case here.J Bangladesh Coll Phys Surg 2016; 34(3): 164-167

Author(s):  
Ramalingappa C. Antaratani ◽  
Shruthi M.

Background: Gestational trophoblastic disease refers to the heterogeneous group of interrelated lesions that arises from abnormal proliferation of placental trophoblasts. GTNs are among the rare human tumours that can be cured even in the presence of widespread dissemination. Although GTNs commonly follow a molar pregnancy, they can occur after any gestational event, including induced or spontaneous abortion, ectopic pregnancy, or term pregnancy. The study was conducted to know the incidence of different types of gestational trophoblastic diseases in the local population and the percentage of people ultimately requiring chemotherapy.Methods: The retrospective analysis of case record of 124 women with a diagnosis of GTD admitted to Karnataka Institute of Medical Sciences Hubli between November 2008 to November 2017.Results: A total of 124 cases of GTD were reviewed. Hydatidiform mole was diagnosed in 91 patients; of those experienced spontaneous remission after evacuation. 04 patients had persistent gestational trophoblastic Neoplasia and 13 cases of invasive mole (GTN) 1 case of epitheloid trophoblastic tumors and 15 cases of choriocarcinoma 99 (80%) had low-risk GTN, 25 (20%) had high-risk GTN.Conclusions: Hydatidiform mole was found to be the most common form of gestational trophoblastic diseases. Majority of the cases got cured by simple surgical evacuation. During the course of our study some rare cases of gestational trophoblastic diseases were noted. Patients’ compliance for serial follow up is a highly challenging task in developing countries. Registration of women with GTD represents a minimum standard of care.


2020 ◽  
Vol 20 (2) ◽  
Author(s):  
Eric Edwin ◽  
Uki Retno Budihastuti ◽  
Cut Sheira Elnita

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


2022 ◽  
Vol 19 (1) ◽  
pp. 22-25
Author(s):  
Kavita Sinha ◽  
Ram Das ◽  
Homnath Adhikari

Introduction: Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases. Vaginal bleeding being the most common occasionally, molar pregnancy is complicated by hyperthyroidism, which may require treatment. Aims: To determine thyroid function test and association of hyperthyroidism among the cases of molar pregnancy. Methods: This is a hospital-based cross-sectional study conducted in the department of Obstetrics and Gynecology, Nepalgunj Medical College and Teaching Hospital, Kohalpur. Sixty cases of molar pregnancy were included during the study period from February 2020 to January 2021.Patients having history of known thyroid disorders were excluded. Results: Prevalence of molar pregnancy in our study was 5.4 per thousand pregnancies in our hospital. Molar pregnancy and hyperthyroidism, both were common in the age group of 21-35 years. Hyperthyroidism was present in 10% patients. Enlarged thyroid was seen in 3.3%, tremor was present in 3.3%, and palpitation in 21.5%. Five (8.3%) patients with hyperthyroidism were underweight. Majority of patients with hyperthyroidism, beta humanchorionic gonadotrophhin level was more than three lakhs and it was mostly associated with complete hydatidiform mole compared to partial hydatidiform mole. Thyroid storm was not experienced in any of the patients. Conclusion: The rate of molar pregnancy is high. Hyperthyroidism in molar pregnancy is not uncommon. High levels of human chorionic gonadotropin, complete hydatiform mole are directly associated with hyperthyroidism. Awareness of this condition is important for diagnosis and treatment to prevent life threatening complications.


Author(s):  
Archana Kumari ◽  
Nikita Chauhan

Background: Gestational Trophoblastic Diseases (GTD) encompass a wide spectrum of proliferative disorders of trophoblast tissue, which hold a good prognosis if diagnosed and treated on time. A close understanding of the disease spectrum is therefore needed to reduce morbidity and mortality.Methods: This is an observational study (both prospective and retrospective analysis) conducted in Rajendra Institute of Medical Sciences, a tertiary care teaching hospital in Ranchi, Jharkhand over a period of 2 years from 1st January 2017 to 31st December 2018.Results: A total of 162 cases of GTD were identified during the study period. Disease spectrum comprised of complete molar pregnancy in 146 (90.12%) and partial molar pregnancy in 7 (4.3%), GTN in 9 out of 162 cases (5.5%). Bleeding per vaginum preceded by amenorrhea was the most common symptom, observed in 95.4% of the cases. Uterine size was more than period of amenorrhea in almost 50% of the cases. Theca lutein cysts were found in 39.8% of the cases, hypertension in 21.5%, hyperthyroidism in 6.5% cases. Overall, there were nine (5.56%) cases of choriocarcinoma and six (3.7%) cases of Invasive mole. Remission rate in GTN was 86.7% with chemotherapy.Conclusions: Women complaining of vaginal bleeding in first half of pregnancy with uterine size more than period of amenorrhea must be evaluated for GTD by ultrasound and serum beta HCG. For cases of molar pregnancies, suction and evacuation remains the treatment of choice but need for regular follow-up and strict compliance to contraception during entire follow up has to be emphasized. Cases of GTN have excellent remission with chemotherapy.


Author(s):  
Jayashree Mulik ◽  
Archana Choudhary

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.


2012 ◽  
Vol 19 (02) ◽  
pp. 159-161
Author(s):  
SYED MEHMOOD HASSAN ◽  
SHOAIB NAYYER I HASHM ◽  
BUSHRA AYAZ ◽  
Faisal Rashid Lodhi ◽  
Kanwal Sohail

Objective: The study was carried out to evaluate the frequency and types of gestational. Trophoblastic diseases (GTD) inendometrial curettings received for histopathology examination. Data Source: Pathology Department, Shifa Naval Hospital Karachi. Design ofStudy: It was a Retrospective Descriptive Observational study. Setting: Department of Pathology, Pakistan Naval Ship; Shifa Naval HospitalKarachi. Period: From 2009 till 2010. Material & Methods: A total of 170 cases of endometrial curettage were examined. All specimensreceived with a diagnosis of product of conceptions (POC) or with the clinical suspicion of a gestational trophoblastic disease were included.Results: It was observed that partial mole identified in 57.1 % cases followed by complete mole 21.4%, choriocarcinoma 14.2% and placentalsite Trophoblastic disease 7.1% cases. Nearly half of the cases were diagnosed as having a gestational trophoblastic disease; these were fromthe age groups of 26-30 years followed by 21-25 years. Conclusions: Hydatidiform mole is the commonest gestational trophoblastic disease.Most complete moles are detected clinically but partial moles are misdiagnosed as abortions therefore all cases of abortions should be sent forhistopathological examinations.


2020 ◽  
Vol 8 (C) ◽  
pp. 226-230
Author(s):  
M. Hristova ◽  
S. Bozhilov ◽  
N. Hristov ◽  
Y. Tancheva ◽  
N. Ivanova ◽  
...  

BACKGROUND: Gestational trophoblastic diseases (GTDs) are a group of rare human tumors by abnormal trophoblastic proliferation. GTD is neoplasia that develops from the trophoblastic element of blastocyst. In this case, some specific features of the trophoblast are retained, while the hCG (Human Chorionic Gonadotropin) synthesis and invasion potential of the underlying tissues are preserved. CASE REPORT: We reported a 55-year-old patient with invasive (destructive) mole hydatidiform “FIGO I” with invasion in myometrium wall. This diagnostic was suggested by abnormal (dysfunctional) vaginal bleeding, amenorrhea period, and low abdominal pain. Our paraclinical investigation was physical examination, transabdominal, and transvaginal ultrasound and complete blood count. Transabdominal and transvaginal ultrasound reveal enlarged uterus volume, with dimensions 18/12/5 cm and with Doppler rich blood supply through myometrium and endometrium. Therapeutic method applied was abdominal hysterectomy and bilateral salpingo-oophorectomy. Anatomopathological report revealed a complete invasive mole. After the surgical intervention, the patient was no treated with methotrexate as prophylactic chemotherapy (recommended by oncologists) because the level of β-hCG was very low. CONCLUSION: Examining the tissue after a miscarriage in women at extreme ages should raise a suspicion of mole. Molar pregnancy should be excluded in these cases.


2021 ◽  
pp. 26-27
Author(s):  
Sona Pathak ◽  
Suraj Sinha ◽  
Md Raihan Md Raihan ◽  
M. A. Ansari

Background: The gestational trophoblastic diseases encompass a wide range of conditions that vary in their clinical presentation, their propensity for spontaneous resolution, local invasion and metastasis and their overall prognosis. Advanced or adolescent maternal age has consistently correlated with higher rates of complete Hydatidiform mole. Material and Methods: It is a retrospective record based study, performed in Department of pathology RIMS, Ranchi. Study population included all cases which were clinically suspected of gestational trophoblastic disease, with common clinical presentation of abnormal vaginal bleeding, amenorrhea, pain abdomen, from January 2017- December 2020. Results: Hydatidiform mole was found to be the most common form of gestational trophoblastic diseases. Our study shows maximum cases of GTD falls in the age group of 20-29 years followed by 30-39 years.


Author(s):  
Hale Goksever Celik ◽  
Gözde Meriç Demirezen ◽  
Baki Erdem ◽  
Alev Atış Aydın ◽  
Volkan Ülker

Twin pregnancies with complete mole and a coexisting live fetus are rare obstetric conditions seen in 1 case of 22000 to 100000 pregnancies. In our case, a twin molar pregnancy was diagnosed in the first trimester by ultrasound. In a 27-year-old patient with the first pregnancy, a 12-week live fetus with a normal placenta and a twin molar pregnancy appearance were observed on a routine ultrasonographic examination of the uterine cavity. Twin molar pregnancies are reported to be terminated by live birth in the literature, but termination of pregnancy is an important option to prevent maternal morbidity since molar pregnancy may lead to complications ranging from theca lutein cysts to gestational trophoblastic neoplasia.


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