A Clinical Study of Hydatidiform Mole (original) (raw)
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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.
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...
The frequency of hydatidiform mole in a tertiary care hospital from central India
IP innovative publication pvt ltd, 2020
Introduction: The gestational trophoblastic disease (GTD) is a group of pregnancy related tumours encompassing complete and partial mole, invasive moles, choriocarcinomas and placental site trophoblastic tumours. Amongst all GTD, hydatidiform moles are the most common form. Hydatidiform mole is a relatively common gynecological condition which could presents like spontaneous abortion, one of the most common gynecological emergencies. Materials and Methods: Present study is a retrospective analysis to determine incidence of hydatidiform mole for eight years duration.All women who were diagnosed of molar pregnancy by estimation of beta hCG and histopathological examination during1st Jan 2010 to 31st Dec 2017 were enrolled in this study. During the study period, there were 84 cases of Molar pregnancy out of 33856 total deliveries. Results: The total number of deliveries reported in the study period was 33856 out of which 84 cases were of gestational trophoblastic disease (GTD). The prevalence of GTD in this tertiary care hospital was 2.48 per 1000 deliveries. During the study period, we had received 55 samples of products of conception and 3079 hysterectomy specimens. Out of 3134 cases, 84 cases were diagnosed as GTD. Out of these 84 cases 81cases were hydatidiform mole. There were two cases of choriocarcinomas and one case of placental site trophoblastic tumour. Conclusion: The prevalence of hydatidiform mole was higher among all entities of gestational trophoblastic disease. The serum beta hCG levels are very sensitive and specific for diagnosis. Histopathological examination is helpful for confirming diagnosis.
Guidelines following hydatidiform mole: A reappraisal
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 2006
Objective: The aim of this study was to determine how often patients with complete hydatidiform mole (CHM) who spontaneously achieve normal human chorionic gonadotrophin (hCG) levels subsequently develop persistent or recurrent gestational trophoblast disease. Methods: Four hundred and fourteen cases of CHM registered at the Hydatidiform Mole Registry of Victoria were reviewed retrospectively after molar evacuation. Maternal age, gestational age, gravidity and parity were determined for each patient, as well as the need for chemotherapy. Results: Among the 414 patients, 55 (13.3%) required chemotherapy for persistent trophoblastic disease. None of the patients whose hCG levels spontaneously fell to normal subsequently developed persistent molar disease. Conclusion: Weekly hCG measurements are recommended for all patients until normal levels are achieved. For patients who attain normal hCG levels within 2 months after evacuation, it seems safe to discontinue monitoring once normal levels are achieved. Patients who fail to achieve normal hCG levels by 2 months after evacuation should be monitored with monthly hCG measurements for 1 year after normalisation to assure sustained remission.
Recurrent partial hydatidiform mole: a report of a patient with three consecutive molar pregnancies
International Journal of Gynecological Cancer, 2006
Hydatidiform mole (HM) is the most common form of gestational trophoblastic neoplasia and is characterized by atypical hyperplastic trophoblasts and hydropic villi. Recurrence of HM is extremely rare. Here, we report the case of a patient with three consecutive partial HMs without normal pregnancy. A 28-year-old woman with gravida 3, para 0, was referred to our hospital with a diagnosis of an invasive mole in December 2003. She had three consecutive molar pregnancies in 2000, 2001, and 2003. All three molar pregnancies were evacuated by suction curettage and the patient was followed by serial β-human chorionic gonadotropin levels. All three moles were histologically confirmed as partial moles. In the first two molar events no additional treatment after evacuation was required, but in the last event, the β-human chorionic gonadotropin levels increased and an invasive mole was suspected. Diagnostic workup ruled out an invasive mole and choriocarcinoma. Karyotypic analysis of the patient and her husband was normal. The patient required chemotherapy for treatment of persistent disease. Recurrent partial HM is a very rare clinical disorder. Repetitive molar pregnancy is not an indication for chemotherapy, but persistent disease does require chemotherapy.
Recurrent hydatiform mole: a rare case report
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
Molar pregnancy is characterized histologically by abnormalities of the chorionic villi that consist of trophoblastic proliferation and oedema of villous stroma. The incidence of hydatiform moles in India is 1 in 1000. The incidence of recurrence is 1 in 60 in a subsequent pregnancy and 1 in 65 in the third pregnancy after two molar pregnancies. The occurrence of hydatiform mole is related to a few risk factors such as smoking, increased paternal or maternal age, and previous history of abortions. Here we report a case of a 29 year old woman with history of four partial moles and two first trimester abortions and her management. The patient finally opted for adoption.
European Journal of Endocrinology, 2005
Objective: Human chorionic gonadotropin (hCG) is widely used in the management of hydatidiform mole and persistent trophoblastic disease (PTD). Predicting PTD after molar pregnancy might be beneficial since prophylactic chemotherapy reduces the incidence of PTD. Design: A retrospective study based on blood specimens collected in the Dutch Registry for Hydatidiform Moles. A group of 165 patients with complete moles (of which 43 had PTD) and 39 patients with partial moles (of which 7 had PTD) were compared with 27 pregnant women with uneventful pregnancy. Methods: Serum samples from patients with hydatidiform mole with or without PTD were assayed using specific (radio) immunoassays for free α-subunit (hCGα), free β-subunit (hCGβ) and ‘total’ hCG (hCG + hCGβ). In addition, we calculated the ratios hCGα/hCG + hCGβ, hCGβ/hCG + hCGβ, and hCGα/hCGβ. Specificity and sensitivity were calculated and paired in receiver-operating characteristic (ROC) curve analysis, resulting in areas under the...
Clinical Findings of Multiple Pregnancy With a Complete Hydatidiform Mole and Coexisting Fetus
Journal of Ultrasound in Medicine, 2010
The aim of this series was to evaluate the clinical features, management, and outcomes of multiple pregnancy with a complete hydatidiform mole and coexisting fetus (CHMCF). Methods. Between 1998 and 2008, we investigated 6 women with a diagnosis of a CHMCF. The gestational age at diagnosis, symptoms, serum b-human chorionic gonadotropin levels, cytogenetic and molecular analysis findings, complications, routes of delivery, and pregnancy outcomes were assessed. Results. All cases were diagnosed before 14 weeks' gestation by sonography. Only 1 ended with the delivery of a live-born neonate, whereas the other 5 cases required termination of pregnancy (TOP) before 21 weeks' gestation because of severe maternal complications (eg, preeclampsia, thyrotoxicosis, lung metastasis, and heavy bleeding) or intrauterine fetal death. The pathologic diagnosis of a complete hydatidiform mole was confirmed in all cases. Two patients required methotrexate for treatment of persistent trophoblastic disease (PTD). Conclusions. On the basis of our experience, in cases with a normal karyotype and no gross fetal abnormalities on sonography, we carefully recommend continuation of pregnancy as long as maternal complications are absent or controllable. However, updated treatment criteria are still needed, and intensive maternal follow-up is necessary in the postpartum period because maternal complications during pregnancy and PTD after TOP are not uncommon.