54 cases of hydatidiform mole pregnancy were studied at the Department of Gynecology and Obsterics of the Central Hospital from June 2000 to July 2001, in comparing with 124 cases of normal immature delivery of living neonate. A high rate of clinical symptoms were noted including vaginal hemorrhage in the first trimester, a more unterine height than in normal fetal age, anemia, severe vomit, pre-eclampsia, hyperthyroidism, luteino-adenoma cyst of > 5 cm diametre. There is a positive relation between vaginal bleeding, uterine height before the curettage and the state of luteino adenoma cyst with Chorio complication. Related factors of hydatidiform mole pregnancy were nutritional status, occupation, age, history of abortment and water source hygiene.
Diagnosis ; Hydatidiform Mole ; Pregnancy

Female ; Humans ; Hydatidiform Mole ; diagnosis ; Pregnancy ; Uterine Neoplasms ; diagnosis

We treated a 54-year-old woman who was suffering from membranoproliferative glomerulonephritis associated with a complete type of hydatidiform mole. The renal manifestations were proteinuria and hematuria. A renal biopsy, performed before gynecologic management, disclosed focal and segmental subendothelial deposits with a proliferation of the mesangial cell and showed irregularly thickened capillary loops by light and electronmicroscoy. Genralized edema, proteinuria and hematuria were completely recovered by suction and curettage of the hydatidiform mole with prophylactic chemotherapy. The clinical manifestation of earlier presented 3 cases have been the nephrotic syndrome. The common feature of them was a complete remission of the nephropathy after the removal of the hydatidiform mole. The relationship between the hydatidiform mole and glomerulonephritis remains unresolved at present. But we concluded that the hydatidiform mole might be a cause of glomerulonephritis in this case.
Case Report ; Diagnosis, Differential ; Edema/etiology ; Female ; Glomerulonephritis, Membranoproliferative/pathology ; Glomerulonephritis, Membranoproliferative/etiology* ; Hematuria/etiology ; Human ; Hydatidiform Mole/therapy ; Hydatidiform Mole/diagnosis* ; Hydatidiform Mole/complications* ; Middle Age ; Pregnancy ; Proteinuria/etiology ; Uterine Neoplasms/therapy ; Uterine Neoplasms/diagnosis* ; Uterine Neoplasms/complications*

Biomedical Research ; trends ; Female ; Humans ; Hydatidiform Mole ; diagnosis ; genetics ; Pregnancy ; Uterine Neoplasms ; diagnosis

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin, and a major risk for persistent trophoblastic tumor. Partial hydatidiform moles appear to be a milder version of complete moles with both normal and cystic villi, focal trophoblastic hyperplsia, a fetus or indication of previous fetal existence, 69 chromosomes with a maternal contribution, and a malignant potential less than described for complete moles. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies. Due to advances in cytogenetics and ultrasonography, now permit the diagnosis of this pregnancy antenatally. However this unusual pregnancy has the risks of malignant change and severe medical complications, so it is a dilemma to decide continuation or termination of pregnancy. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 12 gestational weeks, and confirmed normal karyotype (diploid) of the coexistent fetus. A brief reviews of related literature was done.
Classification ; Cytogenetics ; Diagnosis ; Diploidy ; Female ; Fetus* ; Hydatidiform Mole* ; Hyperplasia ; Incidence ; Karyotype ; Pregnancy ; Trophoblastic Neoplasms ; Trophoblasts ; Ultrasonography

Placental mesenchymal dysplasia is a rare condition of pregnancy that present as macroscopic feature of molar change in the placenta and normal karyotype fetus, and has been reported at birth in 15 cases of Beckwith-Wiedmann syndrome and 25 cases of normal fetus in literatures. It may mimic the partial hydatidiform mole, but the mesenchymal dysplasia is different that it may be compatible with a normal fetus. A nulliparous woman was suspected to be a partial mole with a coexistent live fetus in gestational age of 14 weeks because of the partially cystic placenta on ultrasonography examination. She delivered a healthy female vaginally at 36+6 weeks of gestation and the histological examination of placenta established the diagnosis of mesenchymal stem villous dysplasia. We report here an unusual pregnancy.
Diagnosis ; Female ; Fetus ; Gestational Age ; Humans ; Hydatidiform Mole ; Karyotype ; Molar ; Parturition ; Placenta* ; Pregnancy ; Ultrasonography

PURPOSE: To evaluate the MR findings of gestational trophoblastic tumor(GTT) in correlation with pathological results. MATERIALS AND METHODS: Nine patients who confirmed the diagnosis (four choriocarcinomas and five invasive moles) constituted the basis of our study. Pathologic specimens were taken from the tumors corresponding to the regions of interest on MR images. The MR images were analyzed in respect of the morphology and signal intensity of the tumors, uterine and adnexal vascularity, and the adnexal lesion. RESULTS: The MR findings of four choriocarcinomas were well-defined, hemorrhagic masses with central necrosis;the masses were hyperintense on Tl-weighted images. In contrast, the five invasive moles showed irregular and permeative masses with densely enhanced solid components and tiny cystic lesions. The trophoblastic proliferation, coagulation necrosis, and molar villi had variable signal intensities on Tl-and T2-weighted images. CONCLUSION: Our results suggest that MR imaging is a promising tool for noninvasive morphologic analysis of GTTS.
Choriocarcinoma ; Diagnosis ; Female ; Humans ; Hydatidiform Mole, Invasive ; Magnetic Resonance Imaging* ; Molar ; Necrosis ; Pregnancy ; Trophoblastic Neoplasms* ; Trophoblasts*

This study was conducted to assess the value of DNA diagnosis of gestational trophoblastic disease using polymerase chain reaction method. The 3 genetic loci including a variable number of tandem repeats regions were amplified by the PCR method on DNA of lymphocytes separated from the peripheral blood of the 53 uterine myoma patients. The distribution ranges of the APOB/VNTR, COL2A1/VNTR and MCT 118/VNTR were 691~850 bp, 651~720 bp and 501~720 bp respectively. The heterozygosity indices of the APOB/VNTR, COL2A1/VNTR and MCT 118/VNTR were 66.0%, 64.2% and 67.9% respectively. The author used the hypervariable 3' flanking region of the APOB/VNTR locus as target for DNA diagnosis of gestational trophoblastic disease. In 12 cases of hydatidiform mole, 1 case of invasive mole, and 1 case of choriocaricinoma, the target locus was amplified by the PCR method on DNA from lymphocytes of patients and their husbands, on DNA from the tisues. 10 cases of hydatidiform mole revealed DNA segments unique to the paternal APOB allele showing androgenesis. Two of theses androgenetic hydatidiform noles were heterozygous and the others were homozygous. A case of invasive mole showed normal genetic combination and a case of choriocarcinoma showed homozygosity. The heterozygous hydatidifomr moles as well as the homozygous ydatidiform moles were good in prognosis. The PCR method for targeting the APOB/VNTR appeared useful for the early diagnosis of hydatidiform mole.
3' Flanking Region ; Alleles ; Apolipoproteins B ; Choriocarcinoma ; Diagnosis ; DNA ; Early Diagnosis ; Female ; Genetic Loci ; Gestational Trophoblastic Disease* ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Leiomyoma ; Lymphocytes ; Minisatellite Repeats ; Polymerase Chain Reaction* ; Pregnancy ; Prognosis ; Spouses

OBJECTIVE: To evaluate the clinical characteristics and the outcome of the management for gestational trophoblastic disease (GTD) patients diagnosed at our hospital and to report the current situation of GTD in Korea. METHODS: Between January, 1991, and December, 2000, One hundred and eleven women were diagnosed as GTD and managed in our hospital. Patients were classified according to clinical diagnosis and their medical records were investigated. RESULTS: Cases of benign, malignant nonmetastatic, malignant metastatic low risk and malignant metastatic high risk GTDs were 62, 36, 2 and 11 respectively. The mean age (year), gravidity and parity (number) of GTD patients were 33.3+/-9.9 (range: 19-54), 3.2+/-3.0 (range: 0-16) and 1.7+/-1.8 (range: 0-7) overall. About 75% of GTD patients were women in their 20s and 30s, and 85% occurred in patients with parity of 3 or less. The most common prior gestational event was abortion (37.1%) for molar pregnancy and molar pregnancy (61.2%) for persistent gestational trophoblastic tumor (PGTT). The progression rate of molar pregnancies to PGTT was 38.0%. MTX (16.3%) was mainly used as a single agent, and EMACO (28.6%) or MAC (22.4%) were primarily used for multidrug chemotherapy for the treatment of PGTT. In the treatment of PGTT, overall remission rate was 95.9% (n=47/49). CONCLUSION: The trends for GTD in Korea revealed significant changes, not only a decrease in the incidence of GTD, but also an improvement in the outcome of the management. There is a necessity of further community-based surveys for GTD.
Diagnosis ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gravidity ; Humans ; Hydatidiform Mole ; Incidence ; Korea ; Medical Records ; Parity ; Pregnancy ; Trophoblastic Neoplasms

BACKGROUND: Although the morphological features characteristic of products of conception specimens including molar pregnancies are well described, substantial histopathological similarities are observed between the different entities, especially in cases of early pregnancies. Furthermore, there are no current solid criteria that could predict cases with progression to persistent gestational trophoblastic disease. In this study, we aimed to determine the most specific histopathological and immunohistochemical features required for accurate diagnosis that can reliably predict the clinical behavior. METHODS: Sixty-five cases of products of conception were reviewed clinically and pathologically, and any progression to persistent gestational trophoblastic disease (GTD), if present, was noted. Pathological assessment of the archival material included re-cut sections of 5 μm in thickness, routine staining with hematoxylin and eosin and immunohistochemical staining of p57Kip2. RESULTS: Certain histopathological criteria were found to be significant in differentiation between complete hydatidiform mole (CHM) and partial hydatidiform mole including villous shape and outline, villous trophoblast hyperplasia, and atypia in extravillous trophoblasts. There were no significant differences in any morphological or immunohistochemical features between cases with or without subsequent development of GTD. CONCLUSIONS: Histopathological diagnosis of molar pregnancy remains problematic especially in early gestation. Their diagnosis should be stated after a constellation of specific histopathological criteria in order not to miss CHM. p57Kip2 immunohistochemistry is of great value in diagnosis of cases that had equivocal morphology by histopathological examination. However, there were no significant features to predict cases that subsequently developed persistent GTD.
Diagnosis ; Eosine Yellowish-(YS) ; Female ; Fertilization ; Gestational Trophoblastic Disease ; Hematoxylin ; Hydatidiform Mole* ; Hyperplasia ; Immunohistochemistry ; Molar* ; Pregnancy ; Trophoblasts*