Recurrent hydatiform mole: a rare case report (original) (raw)
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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.
Increased frequency of complete hydatidiform mole in women with repeated abortion
Gynecologic Oncology, 1988
The association between spontaneous abortion and gestational trophoblastic disease (GTD) has been investigated in a study based on 93 women with 2 consecutive (repeated) spontaneous abortions and 82 control subjects who delivered normal babies. Nine molar pregnancies were observed among 7 of the 93 cases of repeated abortion while no control reported previous GTD. This difference was statistically significant and was not explained by allowance for age and number of pregnancies between cases and controls (X~ = 4.20; P = 0.04). When the observed number (9) of hydatidiform mole in the 385 pregnancies of the women with repeated abortion was compared with the expected one (0.28) based on the regional frequency data, the estimated relative risk was 32.1 with a 95% confidence interval from 13.9 to 63.3. The present findings confirm the association between GTD and spontaneous abortion and indicate that the risk is larger in women with repeated abortions.
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.
Partial hydatidiform mole in a postmenopausal IVF pregnancy, retrospective diagnosis: A case report
2016
Introduction: Partial hydatidiform mole pregnancies are very rare. Very few clinicians will come across them during their clinical careers. Partial hydatidiform mole pregnancies that progress have life-threatening obstetric complications. Very few cases of partial hydatidiform mole pregnancies in postmenopausal women have been described in literature. case report: A 56-year-old postmenopausal woman presented with a pregnancy following in vitro fertilization (IVF) treatment. she had her pregnancy complicated by hypertension and intrauterine growth restriction. she delivered by a cesarean section. A genotypically normal looking baby boy was extracted. the neonate died after three days. Histopathological examination revealed a partial hydatidiform mole. conclusion: Partial hydatidiform mole pregnancies can cause maternal mortality and morbidity. Fetal outcomes are generally poor.
Journal of Assisted Reproduction and Genetics, 2018
Benign hydatidiform mole, complete or partial, is the most common type of gestational trophoblastic disease (GTD) characterised by excessive trophoblastic proliferation and abnormal embryonic development. Although most complete hydatidiform moles (CHMs) are diploid androgenetic, a few cases of CHMs are biparental, characterised by recurrence and familial clustering. In these rare cases, mutations in NLRP7 or KHDC3L genes, associated with maternal imprinting defects, have been implicated. Current data regarding future pregnancy options in hydatidiform moles are discussed and our opinion is presented based on an incidence that took place in our hospital with a woman with consecutive molar pregnancies. In recurrent hydatidiform moles, DNA testing should be performed and when NLRP7 or KHDC3L mutation are detected, oocyte donation should be proposed as an option to maximise woman's chances of having a normal pregnancy.
A Rare Case of Large Hydatidiform Mole Mimicking a Term Pregnancy
Kathmandu University Medical Journal
Molar pregnancy is a type of abnormal pregnancy that usually presents with amenorrhea, vaginal bleeding and elevated serum ß-hCG levels. We report a rare case of complete hydatidiform mole occurring in a 46-year-old P2L2 lady who presented with a term size uterus and elevated serum ß-hCG level (> 15,00,000 per deciliter, anemia (hemoglobin: 8.1 g/dL), difficulty in breathing and minimal vaginal bleeding. During the course of her evaluation, she had profuse vaginal bleeding, she underwent suction and evacuation, but bleeding was not controlled despite measures to control it. She was given uterotonics and antifibrinolytic agents and uterine artery ligation. But was proceeded with emergency hysterectomy for uncontrolled hemorrhage. The content of suction and evacuation was vesicles with blood clots and histopathology was reported as complete hydatidiform mole. The patient received a total of 4 units of packed red blood cells. She was discharged from hospital on 5th postoperative day...
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...
Cervical Hydatidiform Moles Pregnancy: Diagnosis and Treatment
Open Access Macedonian Journal of Medical Sciences, 2021
Cervical partial hydatidiform mole is a rare condition and difficult to diagnose. A 39-year-old Balinese woman from Sanglah General Hospital, Bali, Indonesia complained vaginal bleeding with abdominal pain. The patient was diagnosed with a partial hydatidiform mole based on physical examination, ultrasound, beta HCG levels and pathology examinations. Mass evacuation surgery followed by arterial ligation to stop the bleeding and periodically examination of beta HCG levels was carried out until the 14th week after the procedure. Beta HCG decreased gradually to normal level and indicate no risk of trophoblastic malignancy. Establishing the early diagnosis significantly affects the outcome of patient. Keywords: partial cervical hydatidiform mole, blighted ovum, pregnancy, diagnosis, therapy.
A Clinical Study of Hydatidiform Mole
IOSR Journals , 2019
Introduction: Hydatidiform mole is a spectrum of gestational trophoblastic disease resulting from abnormal gametogenesis and fertilization. It is a benign neoplasm of the chorion with malignant potential. The frequency of hydatidiform molein different countries varies and depends on multiple factors. The diagnosis and follow-up is based on ultrasound and serial β-hCG estimation in serum. Objective: To find out the incidence of hydatidiform mole and evaluate the outcome of the disease following treatment. Materials and methods: A cohort study was conducted for a year and a half, among patients with hydatidiform mole. Before and after suction & evacuation, β-hCG monitoring was done. If β-hCG was persistently high, rises again or maintains a plateau in the follow up period, the patient was designated as a case of persistent trophoblastic disease. Results: Sixty cases of hydatidiform mole were studied out of 19,023 pregnancies. The incidence is increased with parity and 21-29 years was the most common age group affected. The most common complaint was vaginal bleeding. Hyperthyroidism was seen in 13.3% cases and bilateral theca luteal cysts were noted in 15% cases. During follow up, β-hCG levels decreased and remained undetectable for 83.3% of the patients while 13.3% and 3.4% had increasing and plateau of β-hCG levels, respectively. Conclusion: In this study, the incidence of hydatidiform mole was 3.1 per 1000 pregnancies. Majority of the cases (83.3%) were successfully treated with suction & evacuation, while 16.7% developed persistent trophoblastic disease requiring chemotherapy.