scholarly journals Partial Mole with a Coexistent Viable Fetus—A Clinical Dilemma: A Case Report with Review of Literature

2014 ◽  
Vol 6 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Archana D Rathod ◽  
SP Pajai ◽  
A Gaddikeri
Keyword(s):  
Case Report ◽  
Normal Pregnancy ◽  
Gestational Trophoblastic Disease ◽  
Review Of Literature ◽  
Female Fetus ◽  
Diploid Female ◽  
Trophoblastic Diseases ◽  
Partial Mole ◽  
Gestational Trophoblastic Diseases ◽  
Clinical Dilemma

ABSTRACT Gestational trophoblastic disease encompasses a diverse group of lesions. If molar changes in the placenta are known along with an alive fetus, then situation is difficult for both obstetrician and parents. On one hand, there may be a normal pregnancy whereas on the other hand the mother may be threatened by numerous complications caused by the hydatid mole, if the pregnancy is continued. We present successfully managed case of partial molar pregnancy with an alive fetus at 1st stage of preterm labor with premature rupture of membranes with anemia with a live diploid female fetus with good neonatal out come. Follow-up till 1 year showed no progression to malignant gestational trophoblastic diseases. How to cite this article Rathod AD, Pajai SP, Gaddikeri A. Partial Mole with a Coexistent Viable Fetus—A Clinical Dilemma: A Case Report with Review of Literature. J South Asian Feder Obst Gynae 2014;6(1):51-55.

scholarly journals GESTATIONAL TROPHOBLASTIC DISEASES;

2012 ◽  
Vol 19 (02) ◽  
pp. 159-161
Author(s):  
SYED MEHMOOD HASSAN ◽  
SHOAIB NAYYER I HASHM ◽  
BUSHRA AYAZ ◽  
Faisal Rashid Lodhi ◽  
Kanwal Sohail
Keyword(s):  
Hydatidiform Mole ◽  
Age Groups ◽  
Gestational Trophoblastic Disease ◽  
Trophoblastic Disease ◽  
Complete Mole ◽  
Trophoblastic Diseases ◽  
Partial Mole ◽  
Gestational Trophoblastic Diseases ◽  
Data Source ◽  
Naval Hospital

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.

scholarly journals Secondary Bone Determinations in Choriocarcinoma

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 37
Author(s):  
C. Berceanu ◽  
M.M. Cîrstoiu ◽  
E. Brătilă ◽  
C. Mehedinţu ◽  
S. Berceanu ◽  
...  
Keyword(s):  
Normal Pregnancy ◽  
Primary Lesion ◽  
Reproductive Age ◽  
Hematogenous Metastasis ◽  
Review Of Literature ◽  
Systematic Assessment ◽  
Trophoblastic Cells ◽  
Trophoblastic Diseases ◽  
Pictorial Essay ◽  
Gestational Trophoblastic Diseases

Abstract Gestational trophoblastic diseases represent a heterogeneous group of disorders that arise from trophoblastic epithelium. Choriocarcinoma is a highly anaplastic malignancy derived from trophoblastic cells. It is characterized by the secretion of human chorionic gonadotropin and early hematogenous metastasis. Metastatic choriocarcinoma in bones is very rare. Gestational trophoblastic diseases can follow normal pregnancy, ectopic pregnancy, abortions or molar pregnancy. However, the presence of bone metastases in a young woman at reproductive age requires systematic assessment for a primary lesion, for 1-2 years. This paper aims to present the bone sites where these metastases can occur, as well as the review of literature supported by a pictorial essay.

scholarly journals Imbalance between matrix metalloproteinases and their tissue inhibitors in preeclampsia and gestational trophoblastic diseases

Reproduction ◽  
2016 ◽  
Vol 152 (1) ◽  
pp. 11-22 ◽  
Author(s):  
Beenish Rahat ◽  
Renuka Sharma ◽  
Rashmi Bagga ◽  
Abid Hamid ◽  
Jyotdeep Kaur
Keyword(s):  
Matrix Metalloproteinases ◽  
Differential Expression ◽  
Normal Pregnancy ◽  
Tissue Inhibitors Of Metalloproteinases ◽  
Tissue Inhibitors ◽  
Trophoblastic Diseases ◽  
Histone Trimethylation ◽  
Gestational Trophoblastic Diseases ◽  
Normal Gestation ◽  
Cancerous Cells

The invasion cascade exhibited by placental trophoblasts and cancerous cells bears many similarities, and it is attributed to extracellular matrix degradation mediated by matrix metalloproteinases (MMPs). Although proper and controlled invasion by trophoblasts into the maternal uterus is an essential requirement for maintenance of normal pregnancy, any abnormality in this phenomenon results in the development of invasion-related disorders such as gestational trophoblastic diseases (GTDs) and preeclampsia. We studied the epigenetic basis of differential expression of two placental MMPs (MMP2andMMP9) and tissue inhibitors of metalloproteinases (TIMP2andTIMP1) during normal gestation and invasion-related disorders, i.e., preeclampsia and GTDs. Our study suggests the association of H3K9/27me3 with differential expression of these MMPs and their inhibitors, which regulate the placental invasion during normal pregnancy, whereas no role of CpG methylation was observed in the differential expression of MMPs/TIMPs. Further, development of GTDs was associated with abnormally higher expression of these MMPs and lower levels of their inhibitors, whereas the reverse trends were observed for MMPs and their TIMPs in case of preeclampsia, in association with abnormal changes in H3K9/27me3. These results suggest the involvement of higher levels of MMPs in an aggressive invasive behavior depicted by GTDs, whereas lower levels of these MMPs in shallow and poor invasive phenotype associated with preeclampsia. Thus, our study shows the significance of a proper balance regulated by histone trimethylation between differential expression of MMPs and their TIMPs for maintaining normal pregnancy and its deregulation as a contributing factor for pathogenesis of invasive disorders during pregnancy.

scholarly journals Study of gestational trophoblastic diseases at a tertiary care hospital in India

2018 ◽  
Vol 7 (4) ◽  
pp. 1622
Author(s):  
Ramalingappa C. Antaratani ◽  
Shruthi M.
Keyword(s):  
Hydatidiform Mole ◽  
Local Population ◽  
Tertiary Care ◽  
Spontaneous Remission ◽  
Standard Of Care ◽  
Gestational Trophoblastic Disease ◽  
Care Hospital ◽  
Case Record ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases

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.

scholarly journals Morbidity and mortality of patients suffering from gestational trophoblastic diseases at the Clinic of gynecology and obstetrics, Clinical center of Serbia in the period from 2000 to 2007

2011 ◽  
Vol 64 (11-12) ◽  
pp. 579-582 ◽  
Author(s):  
Biljana Lazovic ◽  
Vera Milenkovic ◽  
Ljiljana Mirkovic
Keyword(s):  
Risk Factors ◽  
Gestational Trophoblastic Disease ◽  
Morbidity And Mortality ◽  
Trophoblastic Disease ◽  
Gynecology And Obstetrics ◽  
Heterogenous Group ◽  
Clinical Center ◽  
Trophoblastic Diseases ◽  
Potential Risk Factors ◽  
Gestational Trophoblastic Diseases

Introduction. Gestational trophoblastic disease is a heterogenous group of diseases with malignant potential. The aim of this retrospective study was to evaluate potential risk factors in pathogenesis of gestational trophoblastic disease, its morbidity and mortality as well as treatment results. Method. We investigated 82 patients who were treated at the University Clinic of Gynecology and Obstetrics Clinical Center of Serbia from Jan 1st 2000 to Dec 31st 2007. The data were collected from their hospital charts and referred to gynecological anamnesis, diagnosis, protocols of operated patients, diagnosis, histopathological findings, decisions of expert team for trophoblastic disease and hospital discharge. Results. The incidence was 1.5 per 1000 deliveries. The most frequent finding was hydatiform mole (59.8%). The patients were treated by chemotherapy and surgery. All patients survived. Conclusion. The maternal age and a larger number deliveries and abortions are risk factors for gestational trophoblastic disease. The incidence in our clinic is approximately equal to the incidence in western countries in this period.

scholarly journals Spectrum of Gestational Trophoblastic Disease Secondary to Dilation and Evacuation - Our Experience at a Tertiary Care Centre in Mullana, Ambala

2021 ◽  
Vol 10 (16) ◽  
pp. 1106-1113
Author(s):  
Akshat Kuchhal ◽  
Harneet Narula ◽  
Amit Jain ◽  
Shivangi Jain
Keyword(s):  
Wide Spectrum ◽  
Venous Malformation ◽  
Tertiary Care ◽  
Previous History ◽  
Gestational Trophoblastic Disease ◽  
Reproductive Age ◽  
Trophoblastic Disease ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases ◽  
History Of

BACKGROUND Gestational trophoblastic diseases have varying clinical presentations with certain diagnostic signs and symptoms. A strong correlation between gestational trophoblastic diseases (GTD) and a previous history of dilation & evacuation (D & E) has been documented in the limited available literature. We wanted to study the spectrum of gestational trophoblastic disease secondary to dilation & evacuation. METHODS A two-year study including all the females who were admitted to MMIMSR Hospital in view of suspicion of gestational trophoblastic disease was conducted with all having a common history of dilatation and evacuation in the recent past. RESULTS Through the analysis we saw the spectrum of GTD including partial mole, complete mole, invasive mole and choriocarcinoma, as well as its complications in the form of arterio-venous malformation (AVM). CONCLUSIONS The two-year experience suggests that dilatation and curettage may predispose a female of reproductive age group to develop gestational trophoblastic disease in the future. Hence, a high index of suspicion is necessary for timely diagnosis and intervention. The study further helped us understand the wide spectrum of the disease and its associated complications. KEY WORDS Abortion, AVM, Dilatation and Evacuation, GTD, GTN

scholarly journals Gestational Trophoblastic Disease-induced Thyroid Storm

2019 ◽  
Vol 3 (4) ◽  
pp. 409-412
Author(s):  
Carly Blick ◽  
Kraftin Schreyer
Keyword(s):  
Vaginal Bleeding ◽  
The United States ◽  
Gestational Trophoblastic Disease ◽  
Definitive Treatment ◽  
Thyroid Storm ◽  
Trophoblastic Disease ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases ◽  
Life Threatening ◽  
Life Threatening Complication

In the United States, gestational trophoblastic diseases (GTD), including molar pregnancies, occur in 121 out of 100,000 pregnancies.1 Many patients with GTD may develop hyperthyroidism. GTD-induced thyroid storm is a rare but life-threatening complication of GTD.2 Once patients are hemodynamically stable, the mainstay of definitive treatment is evacuation of the mole.3 We present a case of molar pregnancy-induced thyroid storm presenting as vaginal bleeding, fever, and tachycardia.

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 Invasive Molar Pregnancy in a Woman Aged 55 Years: A Case Report

2020 ◽  
Vol 8 (C) ◽  
pp. 226-230
Author(s):  
M. Hristova ◽  
S. Bozhilov ◽  
N. Hristov ◽  
Y. Tancheva ◽  
N. Ivanova ◽  
...  
Keyword(s):  
Case Report ◽  
Complete Blood Count ◽  
Transvaginal Ultrasound ◽  
Abdominal Hysterectomy ◽  
Molar Pregnancy ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases ◽  
Β Hcg ◽  
Invasive Mole ◽  
Prophylactic Chemotherapy

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.

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