Risk Factors for Hydatidiform Mole: Is Husband’s Job a Major Risk Factor? (original) (raw)
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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...
Medical Journal of Indonesia, 2004
Abstrak Penelitian longitudinal prospektif analitik untuk menilai ketepatan prediksi timbulnya penyakit trofoblas ganas melalui sistem penilaian prognosis mola hidatidosa yang dikembangkan oleh NETDC (New England Trophoblast Disease Center) telah dilakukan. Di antara parameter faktor risiko yang dinilai; usia penderita, jenis mola hidatidosa, pembesaran uterus, kadar hCG serum, kista lutein, serta ada- tidaknya komplikasi merupakan factor risiko yang bermakna untuk timbulnya keganasan setelah mola hidatidosa dievakuasi (p=0,032). Penelitian dilakukan pada 50 penderita mola hidatidosa dengan pengamatan lanjutan selama 1 tahun (Januari 2001-Desember 2002) di Bagian Obstetri dan Ginekologi RS Mohammad Hoesin, Palembang. Hasilnya menunjukan prediksi keganasan skor NETDC 50% pada risiko tinggi dan 10% risiko rendah untuk berkembang menjadi ganas (p<0,05). Hasil ini lebih besar dibandingkan dengan nilai yang diajukan WHO yaitu 19-30%. Risiko untuk terjadinya keganasan pasca mola hidatidosa pada kelompok risiko tinggi ialah 9,0 kali lebih tinggi disbanding pada kelompok risiko rendah (CI: 1,769-45,786). (Med J Indones 2004; 13: 40-6) Abstract A prospective longitudinal analytic study assessing the efficacy of NETDC (New England Trophoblastic Disease Center) prognostic index score in predicting malignancy after hydatidiform mole had been performed. Of the parameter evaluated; age of patients, type of hydatidiform mole, uterine enlargement, serum hCG level, lutein cyst, and presence of complicating factors were significant risk factors for malignancy after hydatidiform mole were evacuated (p<0.032). The study were done on 50 women diagnosed with hydatidiform mole with 1 year observation (January 2001-December 2002) at the Department of Obstetrics and Gynecology, Mohammad Hoesin Hospital, Palembang. The results showed that the NETDC prognostic index score predicted malignancy in 50% of high risk group and 10% in low risk group (p<0.05). This showed a higher number than that found by the WHO (19%-30%). The risk for incidence of malignancy after hydatidiform mole in the high risk group is 9.0 times higher compared to that of the low risk group (CI: 1.769-45.786). (Med J Indones 2004; 13: 40-6) Keywords: New England Trophoblastic Disease Center (NETDC), gestational trophoblastic tumor, hydatidiform mole, high and low risk.
Frequency of molar pregnancies in health care centers of tehran, iran
Journal of reproduction & infertility, 2014
Hydatidiform mole is an important obstetric problem which can result in harmful and serious outcomes. In this study, an attempt was made to determine the proportion of hydatidiform mole in prenatal clinics of Iran University of Medical Sciences (IUMS) to find the precise frequency of this disease. Between January 2012 and January 2013, all women who immediately after positive pregnancy test or after retarded menstruation came to prenatal clinics in health care centers of IUMS were included in the study. The women were followed until 8-10 weeks of pregnancy and at this time abdominal sonography was used for confirmation or exclusion of molar pregnancy. In this descriptive study between January 2012 and January 2013, 8614 pregnant women with mentioned criteria were included and 61 cases of hydatidiform mole were diagnosed (0.7% or 7 per 1000 pregnancy). Ten cases (16.4%) were patients with partial moles. There was no significant difference in blood types in molar and non-molar pregnan...
Modern Pathology, 2019
Hydatidiform mole (HM) is an aberrant human pregnancy characterized by excessive trophoblastic proliferation and abnormal embryonic development. HM has two morphological types, complete (CHM) and partial (PHM), and nonrecurrent ones have three genotypic types, androgenetic monospermic, androgenetic dispermic, and triploid dispermic. Most available studies on risk factors predisposing to different types of HM and their malignant transformation mainly suffer from the lack of comprehensive genotypic analysis of large cohorts of molar tissues combined with accurate postmolar hCG follow-up. Moreover, 10-20% of patients with one HM have at least one non-molar miscarriage, which is higher than the frequency of two pregnancy losses in the general population (2-5%), suggesting a common genetic susceptibility to HM and miscarriages. However, the underlying causes of the miscarriages in these patients are unknown. Here, we comprehensively analyzed 204 HM, mostly from patients referred to the Quebec Registry of Trophoblastic Diseases and for which postmolar hCG monitoring is available, and 30 of their non-molar miscarriages. We revisited the risk of maternal age and neoplastic transformation across the different HM genotypic categories and investigated the presence of chromosomal abnormalities in their non-molar miscarriages. We confirm that androgenetic CHM is more prone to gestational trophoblastic neoplasia (GTN) than triploid dispermic PHM, and androgenetic dispermic CHM is more prone to high-risk GTN and choriocarcinoma (CC) than androgenetic monospermic CHM. We also confirm the association between increased maternal age and androgenetic CHM and their malignancies. Most importantly, we demonstrate for the first time that patients with an HM and miscarriages are at higher risk for aneuploid miscarriages [83.3%, 95% confidence interval (CI): 0.653-0.944] than women with sporadic (51.5%, 95% CI: 50.3-52.7%, p value = 0.0003828) or recurrent miscarriages (43.8%, 95% CI: 40.7-47.0%, p value = 0.00002). Our data suggest common genetic female germline defects predisposing to HM and aneuploid non-molar miscarriages in some patients.
Prevalence of molar pregnancy (a three year retrospective study) in a tertiary care ho
2016
Hydatidiform mole is an abnormal gestation characterized by trophoblastic hyperplasia and overgrowth of placental villi. H. mole is classified as complete (CHM) and partial (PHM). The diagnosis is based on histopathology and genetic origin. In our set up, we used only histopathological diagnostic criteria. The incidence of molar pregnancy varies in different parts of the world. The malignant potential of the disease is higher in South East Asia as compared to western countries. Objective of the present study was to determine the frequency, clinical presentation and morphological features of H. mole and compare them with those of other studies. This is a 3 year retrospective descriptive case series conducted in the Department of Pathology, SKIMS Medical College, Bemina from 31 st December 2011 to 31 st December 2014. The case records of all the molar pregnancies during the study period were analysed regarding patient’s history, clinical presentation and morphological features. A to...
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.
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.
Nagoya Journal of Medical Science, 2020
The management of hydatidiform mole (HM) and the incidence of post-molar gestational trophoblastic neoplasia (GTN) in Vietnam has not been reported to date. This study aimed to study the incidence of HM and post-molar GTN and identify factors associated with post-molar GTN at a tertiary hospital in Vietnam. Five hundred and eighty-four patients who were treated for HM at Tu Du Hospital between January and December 2010 were included in this study. The mean age and gestational age at the first evacuation were 28.8 years old and 11.0 weeks, respectively. After the initial evacuation and pathological examination, 87 patients who were older than 40 or did not wish to have children underwent a hysterectomy, while the others underwent second curettage. All 472 patients who had human chorionic gonadotropin (hCG) ≥ 100,000 IU/L before treatment received one cycle of methotrexate with folinic acid as prophylactic chemotherapy. The incidence of HM was 11.1 per 1,000 deliveries; 47 patients (8...
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...