OCCURRENCE, MANAGEMENT AND OUTCOME OF MOLAR PREGNANCIES IN TERTIARY CARE CENTRE, GMCH

Molar pregnancies represent a signi?cant burden of disease on the spectrum of gestational trophoblastic disease. The incidence varies widely in different parts of the world. The objective of this study is to determine the occurrence, management, and outcome of molar pregnancies at our institution. During the study period of 1 year, a total of 36 cases were diagnosed with GTD, giving an incidence of 2.6 per 1000 pregnancies, 2.7 per 1000 deliveries and 2.8 per 1000 livebirths in the department of Obstetrics and Gynaecology, GMCH. Vaginal bleeding was the commonest symptoms (66.66%) apart from amenorrhea. Suction evacuation was the primary mode of treatment (91.66%) and only 4 patients (11.11%) underwent hysterectomy. Chemotherapy was administered in 12 patients. During the follow up period, 5 patients (13.88%) were diagnosed with GTN, 4 of them being invasive mole and 1 being choriocarcinoma. Use of routine ?rst trimester ultrasonography has led to early diagnosis and majority of cases are cured by simple surgical intervention. Longer follow up protocol attribute to poor compliance. A multi-centered study is essential in India to determine the true incidence and overall outcome of molar pregnancy that will help in the understanding of the burden of the disease.

Evaluation of Prevalence of Changes in Thyroid Functional Tests in Mole Hydatiforme

Introduction: Mole hydatiforme is the most common type of gestational trophoblast disease (GTI) and the aim of this study, is evaluation the frequency of changes in thyroid function test in mole hydatidiform patients. Materials and Methods: In this retrospective study, 63 patients with mole hydatidiform who reffering to gynecolgy ward of Ali ibn Abitaleb Hospital in Zahedan from April 2016 to March 2017, were studied. Information such as age, gravidity and laboratory findings inclluding thyroid function test (TFT) and the presence or absence of clinical sympltoms were recorded in the information forms and analyzed by SPSS software. Results: In this study, 63 patients with mole hydatidiform were studied. The mean age of the patients was 26.6 ± 7.7 years. The most common clinical manifestations of hyperthyroidism in patients with mole hydatidorme was tachycardia (39.7%). There was no relationschip between age and gravidity with the hyperthyroid simptoms and thyroid function test. Conclusion: Overall, the results of this study showed ttat 67% of patients with mole hydatidiform hay reduced TSH and more than 50% of cases hay increased free T3 and T4. There was no relationship between maternal age and gravidity with changes in thyroid functional test (AU)

Invasive Mole presenting as Acute Abdomen.

We present a rare case of invasive mole presenting as pain abdomen and bleeding per vaginum with subsequent hemoperitoneum. Emergency hysterectomy confirmed the presence of molar pregnancy perforating through the fundus.

A Case of Hashimoto's Thyroiditis with Transient T3-Thyrotoxicosis Induced by Hydatidiform Mole / 대한내분비학회지

Human chorionic gonadotropin(HCG) is a member of the glycoproteins family synthesized by the placenta, which consists of 2 noncovalently joined subunits(alpha(alpha) and beta(beta)). The alpha- and beta-subunits have a structural homology with the alpha- and beta-subunits of TSH and LH. The thyrotropic action of HCG results from its structural similarity to TSH, so beta-HCG can bind to the TSH receptor in the thyroid gland. A high level of HCG accompanied by an increased thyroid hormone level, can be observed in gestational trophoblastic disease (GTD), such as a hydatidiform mole or a choriocarcinoma, but the clinical symptoms of hyperthyroidism are rarely observed. We experienced a case of Hashimoto's thyroiditis, where the patient was diagnosed with T3-thyrotoxicosis, which had initially been induced by excess beta-HCG due to an H-mole; after evacuation of the H-mole, the condition was diagnosed as hypothyroidism. It has been speculated that a patient with Hashimoto's thyroiditis could have hyperthyroidism, induced by beta-HCG, due to an H-mole

Subsequent Reproductive Experiences after Treatments for Gestational Trophoblastic Disease / 대한산부인과학회잡지

For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.

Metastatic Gestational Trophoblastic Disease in the Lung Occuring with Hydatidiform-mole in Tubal Pregnancy: A case report

Gestational trophoblastic disease associated with the tubal pregnancy is uncommon, and the incidence has been described as 1/5000 tubal pregnancy. We have experienced a case of metastatic gestational trophoblastic disease(GTD) in the lung occuring with complete hydatidiform mole arising in tubal pregnancy. The patient was a 39-year-old, G4P2A2L2 woman with amenorrhea for 5 weeks. Ectopic pregnancy in the right fallopian tube was suspected on transvaginal ultrasonogram. A right adnexectomy was performed. The fallopian tube was markedly dilated and ruptured. The right ovary and a round hematoma had adhered to the external surface of the fallopian tube. On gross examination, no molar tissue was identified. On microscopic examination, the lumen of the dilated fallopian tube was filled with blood clots admixed with several chorionic villi showing hydropic swelling and marked proliferation of atypical trophoblasts. Proliferating syncytio-and cytotrophoblasts invaded the wall of the blood vessels of the fallopian tube and sheets of trophoblasts and some villi were identified in the lumen of blood vessels. Multiple pulmonary nodules thought to be metastatic nodules were identified in the chest X-ray and serum beta-HCG had increased 2 weeks later. This case indicates that a careful pathological examination in the ectopic pregnancy is mandatory, because tubal GTD is not clinically distinguishable from ordinary tubal pregnancy.