11/23. Complete hydatidiform mole and normal live birth following intracytoplasmic sperm injection.A twin pregnancy with complete hydatidiform mole (HM) and preterm birth of a normal female infant after intracytoplasmic sperm injection (ICSI) conception was experienced. ICSI due to severe oligozoospermia was performed on three ova, and three embryos with confirmed two proneclei (2PN) were subsequently transferred to the uterus. At 7 weeks of gestation, molar pregnancy as well as a viable fetus was recognized. At 33 weeks, the pregnancy was terminated due to preterm labor. Dichorionic pregnancy consisting of a normal fetus and placenta in one chorionic membrane and complete HM in the other was recognized. Cytomolecular analysis indicated that the complete HM genome was derived from duplication of a single sperm, and a normal neonate was from biparental genomes. It should be noted that ICSI can avoid incomplete HM (mostly triploid) due to multi-sperm fertilization but might not be able to avoid complete HM (paternal diploid) although such a risk is very low. This is the second report of this condition and is accompanied by the first well-described molecular analysis.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
12/23. hydatidiform mole after in-vitro fertilization: a case report.A 25 year old patient was accepted on the in-vitro fertilization programme at Groote Schuur Hospital in Cape Town and her first IVF cycle resulted in a pregnancy. The patient did not return to the usual follow-up ultrasound until about 4 months after the embryo transfer when an ultrasound revealed the typical picture of a molar pregnancy which was confirmed by histology after evacuation.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
13/23. Recurrent partial hydatidiform mole: report of a case.The first case of recurrent partial hydatidiform mole is reported. Despite worsening of the associated embryopathy, there was no worsening of the histologic characteristics in terms of trophoblastic hyperplasia or behavior. More cases are needed to define the natural history of this recurrent form of trophoblastic neoplasia.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
14/23. Partial hydatidiform mole: ultrasonographic features.Four patients with partial hyatidiform mole managed at the Queen Mary Hospital, hong kong, are described. The diagnosis of blighted ovum or missed abortion was made on the sonographic findings prior to suction evacuation. The dominant features in these cases consisted of a relatively large central transonic area bearing the appearance of an empty gestational sac and surrounded by a thick rim of low-level placenta-like echoes; in contrast with the case of the blighted ovum, a well-defined echogenic sac wall is absent. In another 9 patients with molar pregnancy managed during the same period, the more typical 'snow-storm' vesicular appearance was present. It was concluded that the anembryonic appearance described should alert the sonologist and clinician to the possible diagnosis of partial hydatitiform mole. The evacuated material from the uterine cavity should be examined morphologically and if possible cytogenetically.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
15/23. Complete hydatidiform mole in twin pregnancy: differentiation from partial mole with interphase cytogenetic and DNA cytometric analyses on paraffin embedded tissues.Six cases of hydatidiform mole associated with normal chorionic villi and a normal embryo/fetus (in five cases) were investigated with interphase cytogenetic and DNA cytometric analyses for diagnostic purposes. dna probes specific for the pericentromeric regions of chromosomes 1 and X and for the long arm of chromosome Y were used. In four cases a dizygotic twin pregnancy could be proven. In these cases, the histologically normal chorionic villi showed an XY DNA-diploid pattern, consistent with a normal male conceptus, and the molar chorionic villi a XX pattern. In the other two cases an identical sex chromosomal pattern was found in the normal and in the molar villi (XX/XX and XY/XY respectively). In all six cases the molar placental tissues showed prominent trophoblastic hyperplasia with DNA-polyploidy, consistent with a complete hydatidiform mole. In two cases persistent gestational trophoblastic disease developed. It is emphasized that twin pregnancies composed of a normal conceptus and a complete mole have a relatively high risk for the development of persistent trophoblastic disease and therefore, should be carefully differentiated from triploid partial moles with a relatively low risk of persistent gestational trophoblastic disease. These case reports indicate that additional interphase cytogenetic and DNA cytometric analyses are useful in this differential diagnosis.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
16/23. hydatidiform mole with a surviving coexistent fetus following in-vitro fertilization.A case of a hydatidiform mole with a surviving coexistent fetus following in-vitro fertilization and embryo transfer is reported. The diagnosis was established at 12 weeks gestation and pregnancy was maintained until 31 weeks, during which time transient hyperthyroidism and lung metastasis developed. No difference was observed in pronucleus formation and early embryonic development between the two embryos, which resulted in a complete mole and a normal fetus. DNA finger-print analysis, karyotype analysis and histopathological examination confirmed that the pregnancy was a twin of a complete mole and a normal conception. DNA fingerprint analysis was performed with a single-locus probe cocktail. All DNA bands from the tumour were of paternal origin, and the bands from the placenta were of paternal and maternal origin.- - - - - - - - - - ranking = 3keywords = embryo (Clic here for more details about this article) |
17/23. Tubal hydatidiform mole.We report a tubal hydatidiform mole, most likely resulting from dispermic fertilization. Early hatching of the embryo, because of a defective zona pellucida, may have favored tubal implantation.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
18/23. High incidence of triploidy in in-vitro fertilized oocytes from a patient with a previous history of recurrent gestational trophoblastic disease.The patient described has a history of recurrent gestational trophoblastic disease following spontaneous conception. She subsequently underwent two cycles of in-vitro fertilization (IVF) for management of infertility related to tubal obstruction. IVF of the oocytes retrieved showed a significantly high incidence of abnormal fertilization resulting in the development of triploid embryos. This report explores the possible association of an oocyte defect predisposing to abnormal fertilization, resulting in a high incidence of triploid embryos. Since the development of partial hydatidiform moles is related to the origin of triploidy, this phenomenon is suggested to explain the occurrence of recurrent trophoblastic disease in this patient. We propose the use of intracytoplasmic sperm injection (ICSI) as a therapeutic option to minimize the incidence of triploidy in future IVF cycles; donor oocyte IVF would be another alternative.- - - - - - - - - - ranking = 2keywords = embryo (Clic here for more details about this article) |
19/23. Complete hydatidiform mole with a coexistent embryo.We describe a case of a complete hydatidiform mole with a coexistent embryo. A 19-year-old Hispanic woman presented with an intrauterine pregnancy at 7 weeks gestational age. An ultrasound evaluation at that time showed a gestational sac and fetal heart activity was observed. Four weeks later, subsequent ultrasound study revealed no evidence of an embryo, and a pattern consistent with a hydatidiform mole. Dilation and curettage was subsequently performed that showed a classic hydatidiform mole on histological examination. Chromosome analysis revealed a normal 46,XX karyotype. DNA was extracted from the placental tissue, as well as maternal and paternal blood. Molecular genetic analysis was; performed with four variable number of tandem repeats (VNTR) probes and showed the placental tissue to consist of only paternal DNA with two genomic copies of each allele studied. These findings are consistent with the diagnosis of complete hydatidiform mole and its origin from an empty ovum fertilized by a single sperm. This is the first reported case of a living embryo coexistent with a complete hydatidiform mole documented by genetic analysis.- - - - - - - - - - ranking = 7keywords = embryo (Clic here for more details about this article) |
20/23. Ultrasound appearance of a developing mole.A 40-year-old primigravida at her 9th week of pregnancy presented with uterine bleeding and an ultrasound picture of a non-embryonic pregnancy with an empty gestational sac but a thickened base of high echogenicity. A week later this thickened area showed a placenta-like disc with a picture of early molar change. At ultrasound follow-up, this progressed to a full hydatidiform mole filling the whole of the uterine cavity; the empty gestational sac had disappeared. The molar pregnancy was confirmed histologically following suction evacuation of the uterus. Early ultrasound diagnosis of a non-embryonic pregnancy or a blighted ovum may not rule out the presence of abnormal trophoblast associated with hydatidiform mole. Failed early pregnancies should be evacuated immediately once diagnosed.- - - - - - - - - - ranking = 2keywords = embryo (Clic here for more details about this article) |
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