| nausea and vomiting are common complaints in pregnancy, occurring in more than 50% of pregnant women. Occasionally, the vomiting becomes severe and persistent enough to develop into the syndrome called hyperemesis gravidarum and sometimes requires hospitalization. A 20-year-old woman presented with hyperemesis gravidarum, which was later found to be associated with a molar pregnancy. hyperemesis gravidarum is reported to occur in as many as 26% of molar pregnancies. Increases in the level of serum beta-human chorionic gonadotropin may be the mechanism of hyperemesis gravidarum in molar pregnancy. Hyperthyroid states linked to molar pregnancy may further exacerbate hyperemesis gravidarum. physicians should be aware of this possibility of molar pregnancy in all patients with hyperemesis gravidarum and be familiar with the appropriate management to monitor and prevent an often-fatal trophoblastic neoplasm. ( info) |
2/310. Delivery of a severely anaemic fetus after partial molar pregnancy: clinical and ultrasonographic findings. The incidence of a normal live fetus and a partial molar placenta is extremely rare. Although triploidy is the most frequent association, a fetus with normal karyotype can survive in cases of partial molar pregnancy. We report a case of partial molar placenta in which a live female baby was delivered at 32 weeks gestation by a 30-year-old woman. At the 18th week, ultrasonographic examination revealed a normal fetus with a huge, multicystic placenta. Chromosomal evaluation by amniocentesis revealed a normal female karyotype (46,XX), and serial biometric measurement of the fetus showed normal growth during pregnancy. There were no obstetric complications until the 32nd gestational week when preterm rupture of the membranes occurred. The electronic fetal heart beat tracing showed a repeated sinusoid pattern and late deceleration after admission. The patient underwent emergency Caesarean section and delivered a 1551-g, anaemic female baby with an apgar score of 1, 4 and 6 at 1, 5 and 10 min, respectively. The baby recovered within 2 weeks after respiratory support and transfusion of packed red blood cells. Although anaemia is one of the risk factors that jeopardize the fetus in the case of partial molar pregnancy, termination is not indicated when the fetus is normal and no complications have occurred. ( info) |
| A term twin pregnancy with a complete hydatidiform mole and a normal live fetus is reported. ( info) |
4/310. dna flow cytometric quantification and dna polymorphism analysis in the case of a complete mole with a coexisting fetus. PURPOSE: Our purpose was to investigate whether dna flow cytometric quantification and dna polymorphism analysis are useful for cytogenetic diagnosis in the case of a complete hydatidiform mole that coexists with a living fetus. methods: Flow cytometric analysis of the nuclear dna content and polymerase chain reaction (PCR) amplification of the minisatellite locus with the MCT118 probe were performed on the tissues (fetus, placenta and mole) obtained at the initial evacuation. RESULTS: dna histograms of placental, fetal, and molar tissues showed diploid peaks. PCR products demonstrated that the allele of the mole was homozygous and inherited solely from the husband and that the mole differed genetically from the fetus and the placenta. CONCLUSIONS: These results suggested that dna flow cytometry and dna polymorphism analysis may be useful for the cytogenetic diagnosis of a complete hydatidiform mole and a coexisting fetus. ( info) |
5/310. Exaggerated placental site erroneously diagnosed as non-metastatic trophoblastic disease. A case report. BACKGROUND: Exaggerated placental site (EPS) is classified as a non-neoplastic trophoblastic lesion, and histologically it consists of endometrial and myometrial invasion of intermediate trophoblasts and syncytiotrophoblasts and it differs morphologically from placental site trophoblastic tumors and placental nodules. The purpose of this report is to increase physicians' awareness of this lesion. CASE: A 48-year-old woman with post-molar rising betahCG titers and a clinical diagnosis of non-metastatic trophoblastic disease underwent hysterectomy. Final histopathology showed exaggerated placental site--a lesion often unfamiliar to clinicians. CONCLUSION: It is suggested that operative hysteroscopy may be useful in the diagnosis and management of EPS. ( info) |
| A 38-year-old woman with metastatic choriocarcinoma of the lung had been treated for a hydatidiform mole nine years previously. During the interval she had conceived and given birth to a child. Following lobectomy she has been metastasis-free for five years. ( info) |
| A patient with a triploid partial hydatidiform who had lung metastasis is presented. Complete response was achieved with methotrexate chemotherapy. A review of the literature revealed only 11 previously reported cases. In many of them clinical data are missing. All had lung metastasis and 1 had in addition a metastasis in the vagina. Only 1 of these patients died of disease. The others responded well to chemotherapy. Metastatic trophoblastic disease following partial mole is very rare but the exact prevalence is not known. Since risk factors for developing metastatic trophoblastic disease subsequent to partial mole are not known, all patients should be followed. ( info) |
8/310. Sonolucent areas in the placenta: sonographic and pathologic correlation. With the advent of gray scale ultrasonography, the internal structure of the placenta can be defined in great detail. Subchorionic sonolucent areas visualized on antepartum sonograms correlate with areas of subchorionic fibrin deposition, hematoma, and cystic degeneration in the term placenta. These lesions are apparently of no clinical significance. However, diffuse intraplacental sonolucent cystic lesions are abnormal and are seen in both hydatidiform mole and hydropic swelling of the placenta. ( info) |
9/310. A familial case of recurrent hydatidiform molar pregnancies with biparental genomic contribution. hydatidiform mole is a benign trophoblastic neoplasia characterized by an abnormal development of the embryo and proliferation of placental villi. Using microsatellite markers amplified by the polymerase chain reaction, we have performed a genetic study on eight independent molar tissues occurring in two sisters. karyotype and genotype data demonstrate a diploid and biparental constitution in seven of the analyzed moles suggesting a common mechanism underlying the etiology of the various molar pregnancies in this family. The data reported here suggest that complete and partial hydatidiform moles are not always separate entities and that women with familial recurrent hydatidiform moles are homozygous for an autosomal recessive mutation. ( info) |
10/310. A case of successful conservative chemotherapy for intramural pregnancy. OBJECTIVE: To describe a rare case of intramural pregnancy diagnosed with the use of magnetic resonance imaging (MRI) and conservatively managed. DESIGN: Case report. SETTING: Department of obstetrics and gynecology in a university hospital. PATIENT: A 33-year-old healthy patient with a history of a partial mole after 3 years of primary unexplained infertility. INTERVENTION(S): Laparoscopic and transvaginal local injections of methotrexate. MAIN OUTCOME MEASURE(S): Transvaginal ultrasound (US) and MRI findings. RESULT: Treatment was successful, with no complications, and the patient's reproductive potential was preserved. CONCLUSION(S): Early detection of intramural pregnancy with the use of transvaginal US is important, and MRI is a useful, noninvasive imaging modality. Chemotherapy with methotrexate is an effective treatment that allows preservation of reproductive potential. ( info) |