Hydatidiform Mole. Mamdoh Eskandar FRCSC. Gestational trophoblastic Disease. Molar pregnancy -Complete hydatiditform mole -Incomplete hydatiditform mole Choriocarcinoma Placental-site trophoblastic tumor. Complete mole - Fertilization an empty egg by one sperm.
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Mamdoh Eskandar FRCSC
-Complete hydatiditform mole
-Incomplete hydatiditform mole
- Fertilization an empty egg by one sperm.
-All placental villa swollen.
-Fetus, cord, amniotic membrane are absent.
-Paternal chromosomes only. 46 XX.
-fertilization of an egg by two sperms
-some placental villa swollen
Fetus, cord, amniotic membrane are present
Paternal and maternal
-In USA 1:1000
-In Asia 8:1000
-Extreme of age
-Lower socioeconomic status
-Race and ethnic origin
-Blacks have lower incidence
-Abnormal bleeding in early pregnancy
-Lower abdominal pain
-Toxemia before 24 weeks of gestation
-Uterus large for dates
-No fetal heart rate
-Enlargement of the ovaries
-Expulsion of swollen villi
-Ultrasound shows snowstorm-like appearance, no fetus, theca lutein cyst
-Beta hCG in normal pregnancy the level is at it peak at around 14 weeks (100,000 mIU/ml)
TORONTO, CANADA, 1998, SANT.JOS. HOS.
Correct: anemia, toxemia, hyperthyroidism, pulmonary compromise.
-HCG level is increasing or plateaus
-Metastasis disease is present
-HCG level is still elevated after 6 months of evacuation
-HCG starts to rise after being undetectable
I. Confined to corpus uteri
II. Metastases to vagina or pelvic organs
III. Metastases to lungs
IV. Distant metastases
the opposite of good prognosis