Abnormal Development - Hydatidiform Mole: Difference between revisions
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==Some Recent Findings== | ==Some Recent Findings== | ||
[[File:Molar pregnancy 01.jpg|thumb|Uterus with Molar Pregnancy<ref><pubmed>22928132</pubmed>| [http://www.hindawi.com/journals/criog/2012/405085 Case Rep Obstet Gynecol.]</ref>]] | |||
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==Mole Types== | ==Mole Types== | ||
[[File:Hydatidiform_mole_01.jpg|thumb|Complete mole pathology and multiple fibroids within the uterus.<ref><pubmed>22928132</pubmed>| [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424659 PMC3424659/] | [http://www.hindawi.com/crim/obgyn/2012/405085 Case Rep Obstet Gynecol.]</ref>]] | [[File:Hydatidiform_mole_01.jpg|thumb|Complete mole pathology and multiple fibroids within the uterus.<ref><pubmed>22928132</pubmed>| [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424659 PMC3424659/] | [http://www.hindawi.com/crim/obgyn/2012/405085 Case Rep Obstet Gynecol.]</ref>]] | ||
===Complete Mole=== | ===Complete Mole=== | ||
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[[Category:Week 2]] | [[Category:Abnormal Development]] [[Category:Placenta]] | [[Category:Week 2]] | [[Category:Abnormal Development]] [[Category:Placenta]] |
Revision as of 13:44, 10 May 2014
Embryology - 10 Jun 2024 Expand to Translate |
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Introduction
(hydatiform mole, hydatid mole, molar pregnancy, gestational trophoblastic disease) Another type of abnormality is when only the conceptus trophoblast layers proliferates and not the embryoblast, no embryo develops, this is called a "hydatidiform mole", which is due to the continuing presence of the trophoblastic layer, this abnormal conceptus can also implant in the uterus. The trophoblast cells will secrete human chorionic gonadotropin (hCG), as in a normal pregnancy, and may appear maternally and by pregnancy test to be "normal". Prenatal diagnosis by ultrasound analysis demonstrates the absence of a embryo.
There are several forms of hydatidiform mole: partial mole, complete mole and persistent gestational trophoblastic tumor. Many of these tumours arise from a haploid sperm fertilizing an egg without a female pronucleus (the alternative form, an embryo without sperm contribution, is called parthenogenesis). The tumour has a "grape-like" placental appearance without enclosed embryo formation. Following a first molar pregnancy, there is approximately a 1% risk of a second molar pregnancy.
- The incidence of hydatidiform mole varies between ethnic groups, and typically occurs in 1 in every 1500 pregnancies.
- All hydatidiform mole cases are sporadic, except for extremely rare familial cases.
- A maternal gene has been identified for recurrent hydatidiform mole (chromosome 19q13.3-13.4 in a 15.2 cM interval flanked by D19S924 and D19S890).[1]
- Links: Hydatidiform Mole | Meiosis | Oocyte Development | Week 2 - Abnormalities | Placenta - Abnormalities | Abnormal Development
Some Recent Findings
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More recent papers |
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This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.
More? References | Discussion Page | Journal Searches | 2019 References | 2020 References Search term: Hydatidiform Mole <pubmed limit=5>Hydatidiform Mole</pubmed> |
Mole Types
Complete Mole
Only paternal chromosomes.
- Chromosomal genetic material from the ovum (egg) is lost, by an unknown process.
- Fertilization then occurs with one or two sperm and an androgenic (from the male only) conceptus (fertilized egg) is formed.
- With this conceptus the embryo (fetus, baby) does not develop at all but the placenta does grow.
- placenta it is abnormal and forms lots of cysts and has no blood vessels.
- These cysts look like a cluster of grapes and that is why it is called a hydatidiform ("grape-like") mole.
- A hydatidiform mole miscarries by about 16 to 18 weeks gestational age.
- Since the diagnosis can be made by ultrasound before that time, it is better to have an evacuation of the uterus (D & C) so that there is no undue bleeding and no infection.
- Human chorionic gonadotropin (hCG) levels will assist in making the diagnosis.
Partial Mole
Three sets of chromosomes instead of the usual two and this is called triploidy.
- chromosomal (genetic) material from the ovum (egg) is retained and the egg is fertilized by one or two sperm.
- with partial mole there are maternal chromosomes and there is a fetus.
- the three sets of chromosomes means the fetus is always grossly abnormal and will not survive.
(Text modified from: International Society for the Study of Trophoblastic Diseases, see also JRM Gestational Trophoblastic Disease)
Tumour Growth
Like any tumour, unless removed there is a risk of progression:
- Stage I: Tumor confined to uterus (non-metastatic)
- Stage II: Tumor involving pelvic organs and/or vagina
- Stage III: Tumor involving lungs, with or without involving pelvic structures and/or vagina
- Stage IV: Tumor involving distant organs
Choriocarcinoma
A highly malignant epithelial tumour often associated with hydatidiform mole.
Placental Mesenchymal Dysplasia
A rare disorder due to a similar "grape-like" placental appearance, this rare disorder has been mistaken both clinically and macroscopically for a partial hydatidiform molar pregnancy. Characterized by an increased size placenta with cystic villi and dilated vessels. This disorder also has a high incidence of intrauterine growth restriction (IUGR) and fetal death.
Twin Pregnancy Mole
Hydatidiform mole and co-existent healthy fetus is a very rare condition with only 30 cases documented in detail in the literature.[6]
Ectopic Molar Pregnancy
Left-sided unruptured ampullary ectopic pregnancy at laparoscopy.[7]
- Links: Ectopic Implantation
References
- ↑ <pubmed>10072436</pubmed>
- ↑ <pubmed>22928132</pubmed>| Case Rep Obstet Gynecol.
- ↑ <pubmed>22198244</pubmed>
- ↑ <pubmed>22928132</pubmed>| PMC3424659/ | Case Rep Obstet Gynecol.
- ↑ <pubmed>19774194</pubmed>
- ↑ <pubmed>18273627</pubmed>
- ↑ <pubmed>22655097</pubmed>
Reviews
<pubmed>22085657</pubmed> <pubmed>21293291</pubmed> <pubmed>20367628</pubmed> <pubmed>20673583</pubmed>
Articles
<pubmed></pubmed>
OMIM
Search PubMed
Search PubMed Now: Hydatidiform Mole
Additional Images
Historic Images
External Links
External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.
- PubMed Health Hydatidiform mole
- International Society for the Study of Trophoblastic Diseases
- Sydney Gynaecological Oncology Group Gestational Trophoblastic Disease
- The Journal of Reproductive Medicine Gestational Trophoblastic Disease (1998)
- Dana-Farber Cancer Institute Gynecologic Oncology Program
Glossary Links
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Cite this page: Hill, M.A. (2024, June 10) Embryology Abnormal Development - Hydatidiform Mole. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Hydatidiform_Mole
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G |