Increased frequency of complete hydatidiform mole in women with repeated abortion (original) (raw)
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American journal of clinical pathology, 1996
The authors studied the prevalence and significance of implantation site trophoblastic atypia in hydatidiform moles and spontaneous abortions. Three pathologists independently categorized 99 early abortion specimens regarding diagnosis (spontaneous abortion, partial hydatidiform mole, complete hydatidiform mole); qualitative atypia of implantation site trophoblast (absent, mild, moderate-severe); and quantitative atypia of implantation site trophoblast (absent, focal, diffuse). Interobserver agreement was good to excellent regarding diagnosis (kappa 0.66-0.79) and poor to fair regarding qualitative atypia of implantation site trophoblast (kappa 0.20-0.43). By consensus diagnosis, implantation site trophoblastic atypia was mild and focal in 5% of 22 spontaneous abortions; predominantly focal in 40% of 30 partial moles (33% mild atypia; 7% moderate-severe atypia); and, predominantly diffuse in 87% of 47 complete moles (21% mild atypia; 66% moderate-severe atypia). Among hydatidiform m...
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1997
Ob/eetive: The current study was undertaken in order to identify the clinical characteristics and natural history, as well as methods of investigation and available therapy, of persistent gestational trophoblastic disease (GTD) following the evacuation of partial hydatidiform mole (PM). Methods': Case reports of persistent GTD following the evacuation of partial mole, were searched using the Medline computerized retrieval system. There were 66 such cases (including 4 cases treated at our department), representing 2.9% of GTD following PM. Results: The mean age of the women at diagnosis was 28.4 years and mean gravidity was 2.99. The mean gestational age at diagnosis was 15.5 weeks and the mean uterine size was 13.6 weeks. The most common presenting symptom was vaginal bleeding. In the majority of the patients, the pre-evacuation diagnosis was incomplete or missed abortion. Conclusions: Although the malignant potential of PM is low, persistent GTD may develop after PM and may even metastasize, it is usually responsive to single agent chemotherapy but may require combination chemotherapy. Therefore, after evacuation of PM, these women should be followed with serial serum b-hCG. Further research is needed to enable earlier identification of PM that eventually will develop persistent GTD.
Clinicopathological Study of Gestational Trophoblastic Disease (GTD) in a Tertiary Care Hospital
Indian Journal of Gynecologic Oncology, 2023
Purpose This is a prospective observational study from November 2020 to 2022 over 104 cases with an objective (a) to determine the incidence along with the clinicopathologic characteristics, (b) to find risk factors associated and its management (c) to evaluate the outcome of GTD after follow-up. Methods After detailed clinical and laboratory investigation, all cases of molar pregnancy were subjected for suction and evacuation followed by histopathological study and serum b-hCG. During its follow up visit, detailed history for signs and patterns of serum b-hCG was noted, categorized as high risk or low risk GTN and treated accordingly. Results The incidence was found to be 4.6/1000 pregnancies. A maximum of 66 cases (63.4%) were of O?ve, mostly presenting with amenorrhea. 84 cases (80.8%) were hydatidiform mole and 20 cases (19.2%) were of pGTT with 80 cases (76.9%) complete mole, 04 cases (3.8%) partial mole, 15 cases (14.4%) invasive mole and 5 cases (4.8%) choriocarcinoma. Suction & evacuation was done in all 86 cases (82.6%) of hydatidiform mole, hysterectomy in 12 cases (11.5%) and chemotherapy in 45 cases (43.2%) of GTN among which 40 cases (88.9%) completed follow up of 6 months with remission and only 5 cases (11.1%) developed resistant. FIGO scoring system showed 20 cases (44.4%) of low risk, 16 cases (35.5%) of medium risk and 9 cases (20%) of high risk. Conclusion Routine ultrasonography, appropriate diagnosis, treatment and follow up leads to near 100% cure. A multicentered study and proper counseling is essential to determine the true incidence and overall outcome of molar pregnancy. Keywords GTD b-hCG Chemotherapy Hydatidiform mole
Maternal Age-Related Rates of Gestational Trophoblastic Disease
Obstetrics & Gynecology, 2008
To estimate the incidence of gestational trophoblastic disease in Nova Scotia and to evaluate the effect of time and maternal age on these rates. METHODS: Information on women with a pathologically confirmed diagnosis of gestational trophoblastic disease was extracted from the Nova Scotia Gestational Trophoblastic Disease Registry between 1990 and 2005. The total numbers of deliveries and pregnancies were determined from the Nova Scotia Atlee Perinatal Database and consensus data derived from Statistics Canada. RESULTS: Four-hundred twenty-eight women were identified with gestational trophoblastic disease. Hydatidiform moles showed rates of 220/100,000 pregnancies, 264/100,000 total births, and 266/100,000 live births. Rates of partial mole were twofold higher than complete mole (P<.001). The rates of hydatidiform mole were highest in both younger (younger than 20 years old, P)20.؍ and older age groups (30-34 years old, P,40.؍ and at least 35 years old, P.)20.؍ The rates of hydatidiform mole were highest in both younger (less than 20 years old, P)20.؍ and older age groups (30-34 years old, P .04, and 35 or more years old P.)20.؍ The rates of partial moles were significantly higher in women older than 20 years of age (P<.001) and increased with increasing age (P<.001); the reverse trend was seen in complete mole (P<.001). There was no temporal change in rates or average age of hydatidiform mole during the study period. CONCLUSION: The rates of hydatidiform mole in Nova Scotia estimated by this population-based study using comprehensive validated information, are higher than most previously reported. Maternal age was a significant factor in the risk for molar pregnancies.
African health sciences, 2002
To determine epidemiological characteristics and clinical presentation of complete hydatidiform mole (CHM) and complications associated with prophylactic chemotherapy with oral methotrexate. Mulago hospital, Kampala. Prospective study. Ninety-four patients with clinically and histologically confirmed complete hydatidiform mole admitted between 1/9/1995 and 30/1/1998 were followed for periods ranging from 12 months to 30 months. Seventy-eight (83.0%) received a total of 187 courses of oral methotrexate (0.4 mg/kg daily in 3 divided doses) as prophylactic chemotherapy. The main outcome measures were pre- and post-evacuation serum hCG levels and complications associated with oral methotrexate use. The prevalence of CHM was 3.42 per 1000 deliveries. The mean age of subjects was 29.6 + 8.5 years. Eighteen women (19.1%) were nulliparous and mean gravidity was 8.3. Many women presented with high-risk disease. Risk factors for persistent trophoblastic disease were prior molar pregnancy, age...
Gestational Trophoblastic Disease
Clinical Obstetrics and Gynecology, 2007
Hydatidiform mole, a disorder of fertilization, comprises complete and partial molar pregnancy. The pathologic and clinical features of complete and partial mole are well-described.
Journal of gynecology and womens health, 2017
Hydatidiform mole (HM) is a complication of pregnancy, genetically abnormal, characterized by several degrees of trophoblastic proliferation and hydropic degeneration of chorionic villi with potential for malignant transformation. The HM is classified as complete hydatidiform mole (CHM) and partial hydatiform mole (PHM). The distinction between CHM and PHM and non-molar abortions (NM) is very important since the risk for the development of postmolar gestational trophoblastic neoplasia is higher in CHM. This article is a brief review of relevant topics about genetic, histological and clinical features of molar pregnancy.
The Malaysian journal of pathology, 1993
A review of gestational trophoblastic disease diagnosed at the Department of Pathology, University Hospital, Kuala Lumpur from January 1989 to December 1990 using established histological criteria showed 25 complete hydatidiform moles (CHM), 11 partial hydatidiform moles (PHM), 1 invasive mole and 2 choriocarcinoma. The ages of the patients with CHM ranged from 21 to 43 years (mean = 28.5 years) and PHM 20 to 33 years (mean = 27.5 years). The invasive mole occurred in a 42-year-old Malay woman. The two patients with choriocarcinoma were both Chinese and 41 and 46-years old respectively. During the same period, 1,062 non-molar abortions and 13,115 births, inclusive of livebirths and stillbirths were recorded at the University Hospital. The incidence rate of hydatidiform moles was thus estimated to be 1:384 pregnancies. PHM constituted 30% of all molar pregnancies. Hydatidiform moles occurred among the Malays, Chinese and Indians at the rate of 2.43, 2.66 and 3.29 per 1,000 pregnancie...