1/23. 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.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
2/23. Twin pregnancy with a complete hydatidiform mole and co-existing fetus following in-vitro fertilization: case report.hydatidiform mole with a co-existing live fetus is a rare event. We report the case of a 41 year old Caucasian woman who attended for in-vitro fertilization. Three embryos, containing two apparently normal pronuclei, were transferred into the uterus. A twin pregnancy with a live fetus and a complete mole ensued. The pregnancy was managed conservatively until 28 weeks gestation when, following an episode of major antepartum haemorrhage, a live female infant was delivered by Caesarean section. The mole, weighing over 1.7 kg, was successfully evacuated. Following delivery, serum human chorionic gonadotrophin concentrations returned to baseline and remain within the normal range at 24 months. Both mother and daughter are well on assessment 24 months later.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
3/23. Repetitive complete hydatidiform mole can be biparental in origin and either male or female.Complete hydatidiform mole (CHM) is an abnormality in pregnancy due to a diploid conception which is generally androgenetic in origin, i. e. all 46 chromosomes are paternally derived. We have examined the genetic origin of repetitive hydatidiform moles in a patient having three CHM by two different partners, and no normal pregnancies. Using fluorescent microsatellite genotyping, we have shown all three CHM to be biparental, rather than androgenetic, in origin. Examination of informative markers for each homologous pair of chromosomes, in two of the CHM, failed to reveal any evidence of unipaternal disomy, suggesting that the molar phenotype might result from disruption of normal imprinting patterns due to a defect in the maternal genome. It has been suggested that intracytoplasmic sperm injection (ICSI), followed by selection of male embryos, can prevent repetitive CHM; but examination of sex chromosome-specific sequences in the three CHM described here, showed that, while two were female, the first CHM was male. Selection of male embryos is therefore unlikely to prevent repetitive CHM in this patient. Our results suggest that the genetic origin of repetitive CHM should be determined prior to in-vitro fertilization (IVF) and that current strategies for the prevention of repetitive CHM may not be appropriate where the CHM are of biparental origin.- - - - - - - - - - ranking = 2keywords = embryo (Clic here for more details about this article) |
4/23. Hydatiform mole with coexisting live fetus in dichorionic twin gestation.A case of dichorionic twin pregnancy was diagnosed in a 29-year-old, on routine ultrasound at 12 weeks. Subsequent ultrasounds for persistent vaginal bleeding at 16 weeks revealed molar placenta with viable fetus in both gestational sacs. The patient declined any invasive prenatal testing to confirm the karyotype of the fetus. The pregnancy was managed expectantly until 21 weeks, when she had a spontaneous abortion of twin fetuses and separate placentae with attached molar tissue. A final karyotype on cord blood samples confirmed 46XY and 46XX for both fetuses. Histopathology of molar tissue reported complete mole, with diploid chromosomal pattern on subsequent dna flow cytometry. The clinical, ultrasound and chromosomal examination suggest that there has been a quadruplet pregnancy where two embryos developed into normal fetuses and other two degenerated to complete moles.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
5/23. molar pregnancy with a coexistent fetus after intracytoplasmic sperm injection. A case report.BACKGROUND: Normal fertilization is usually considered to have occurred when two pronculei (2PN) and two polar bodies are observed. Exceptions are the single pronucleated zygote resulting from asynchronous pronuclei. CASE: A 29-year-old woman entered a program of intracytoplasmic sperm injection and embryo transfer because of her husband's oligoasthenoteratozoospermia. Two cleavage-stage embryos (four blastomeres, grade 1 and 2) were obtained from one fertilized oocyte containing distinct 2PN and the other a single pronucleus (1PN). At 15 weeks' gestation the patient developed severe preeclampsia requiring termination of the pregnancy. Histopathologic examination and dna ploidy by image analysis were consistent with a twin pregnancy combining a complete hydatidiform mole and normal pregnancy. CONCLUSION: We hypothesize that this 1PN was at the origin of the hydatidiform mole. This case highlights the danger of transferring an embryo having 1PN.- - - - - - - - - - ranking = 3keywords = embryo (Clic here for more details about this article) |
6/23. A case of twin pregnancy with complete hydatidiform mole and coexisting fetus following IVF-ET.Twin pregnancy consisting of complete hydatidiform mole (H-mole) and a coexisting fetus occurs with an estimated incidence of 1 per 22,000-100,000 pregnancies. The incidence of this unusual twin pregnancy with complete H-mole and a coexisting fetus after in vitro fertilization and embryo transfer (IVF-ET) is not thought to be greater than that of general population. We present an unusual twin pregnancy with complete H-mole and a coexisting fetus that occurred following IVF-ET, which was terminated at 21 weeks of gestation and developed into nonmetastatic gestational trophoblastic tumor.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
7/23. Complete hydatidiform mole retaining a chromosome 11 of maternal origin: molecular genetic analysis of a case.Hydatidiform moles are pregnancies characterized by abnormal development of both embryonic and extraembryonic tissues and are associated with the misexpression of imprinted genes. The vast majority of complete hydatidiform moles are diploid and androgenetic, whereas partial hydatidiform moles are triploid, with an extra set of chromosomes of paternal origin. Here, we present an unusual complete mole that showed strong expression of two imprinted, maternally transcribed genes, CDKN1C (encoding p57(KIP2)) and PHLDA2 (TSSC3/IPL), both part of a large imprinted gene domain on chromosome 11. Using microsatellite genotyping and fluorescent in situ hybridization, we show that this paradoxical gene expression was due to retention of a maternal copy of chromosome 11 in addition to the two paternal copies normally present in complete moles. These findings demonstrate that, despite being predominantly androgenetic, some complete moles contain small amounts of dna of maternal origin. Furthermore, these results provide an explanation for rare false negatives that can arise when p57(KIP2) is used as a diagnostic marker for complete moles.- - - - - - - - - - ranking = 2keywords = embryo (Clic here for more details about this article) |
8/23. Partial hydatidiform mole following the transfer of single frozen-thawed embryo subsequent to ICSI.Hydatiform mole is a gestational trophoblastic disease characterized by the dominance of dispermic fertilization. micromanipulation techniques in assisted reproduction technologies have enabled direct evaluation of the zygotes and the formation of pronuclei in the zygote. Intracytoplasmic sperm injection (ICSI) of oocytes ensures that only a single spermatozoon enters the ooplasma. This study reports a case of partial hydatiform mole following the transfer of day 3 frozen-thawed embryo. ICSI was used as the assisted fertilization method because there was male factor infertility due to severe oligoasthenoteratozoospermia. Possible predisposing factors for partial hydatidiform mole after ICSI are also discussed.- - - - - - - - - - ranking = 5keywords = embryo (Clic here for more details about this article) |
9/23. First trimester diagnosis of partial mole.BACKGROUND: Partial mole is one of the two distinctive subtypes of hydatidiform mole. It is usually paternally derived triploid conceptions in which embryonal development occurs in association with trophoblastic hyperplasia. The definite diagnosis is confirmed by pathological and cytogenetic studies. Ultrasound might be helpful to diagnose partial mole in the first trimester. CASE: A 25-year-old woman, gravida 2, para 0-0-1-0, was initially seen for antenatal care at 6 weeks' pregnant. Ultrasound was undertaken at 13 weeks' pregnancy due to her first fetal anomaly, which demonstrated partial mole and embryonic death. The serum beta hCG was 190,900 mIU/ml. suction curettage was performed without complication. Histopathological study confirmed partial mole and cytogenetic study of the placenta revealed an uncommon karyotype, mosaicism of triploid (69,XXX/69,XXY). serum beta hCG was declined and negative at 8 weeks. The patient was well and serum beta hCG remained normal throughout 6 months of follow-up. CONCLUSION: Although the majority of partial mole pregnancies cannot be detected by routine first trimester ultrasound examination, first trimester ultrasound can be helpful in some cases, such as this one. If partial mole is sonographically suspected, it should be confirmed with histopathology and cytogenetic studies. The management is similar to complete mole including prompt evacuation and careful monitoring of beta hCG.- - - - - - - - - - ranking = 2keywords = embryo (Clic here for more details about this article) |
10/23. hysterectomy in a malignant molar pregnancy and a healthy baby.hydatidiform mole is a degenerative chorion disturbance of unknown etiology. It is characterized by a permanent whitish enlargement of the chorionic villi with a grape-like appearance and poor vascularization. The symptoms of a molar pregnancy are nausea and vomiting which are present in more than one-third of the patients. Other symptoms include an enlarged uterus and vaginal bleeding. Our patient was a 19-year-old primipara with a twin pregnancy where one embryo was molar. diagnosis was confirmed by beta-hCG levels.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
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