Materiały źródłowe

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-Molar-Pregnancy.aspx

  A molar pregnancy is often completely asymptomatic, and the diagnosis is made only when the first pregnancy scan routinely scheduled at 10 to 14 weeks reveals the problem. […] A pelvic ultrasound scan will show the presence of tissue inside the uterus, with the characteristic snowstorm appearance of a molar pregnancy. […] When a patient presents with early pregnancy bleeding or other abnormal pregnancy features, an ultrasound scan is usually recommended. This may show the characteristic features of a hydatidiform mole. […] When the ultrasound does not provide characteristic features of molar pregnancy, or looks like a miscarriage, the woman may be advised to have her hCG levels checked as well to differentiate between several possible diagnoses. […] Ultrasound scanning shows a honeycomb pattern produced by the numerous vesicles. As they enlarge the image is described to look like a snowstorm, which is due to swollen cysts with bleeding into the uterus. […] If the diagnosis is in doubt, a repeat scan is ordered after a week or two. In almost all partial moles the fetus is aborted spontaneously, and the diagnosis is established by microscopic examination and cytogenetic study of the aborted tissue.

• #1 Molar pregnancy – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/diagnosis-treatment/drc-20375180

  During a transvaginal ultrasound, a healthcare professional or technician uses a wandlike device called a transducer. […] A health care provider who suspects a molar pregnancy is likely to order blood tests and an ultrasound. […] As early as eight or nine weeks of pregnancy, an ultrasound of a complete molar pregnancy might show: No embryo or fetus, No amniotic fluid, A thick cystic placenta nearly filling the uterus, Ovarian cysts. […] An ultrasound of a partial molar pregnancy might show: A fetus that’s smaller than expected, Low amniotic fluid, Placenta that appears unusual. […] After finding a molar pregnancy, a health care provider might check for other medical issues, including: Preeclampsia, Hyperthyroidism, Anemia. […] After the molar tissue is removed, a provider keeps measuring the HCG level until it goes down.

• #1 Diagnosing molar pregnancy | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/gestational-trophoblastic-disease-gtd/molar-pregnancy/diagnosing-molar-pregnancy

  Molar pregnancy is usually diagnosed during routine pregnancy tests and scans. […] Measuring the levels of hCG in your blood and urine can help to diagnose a molar pregnancy. […] Pelvic ultrasound scans are a good way of diagnosing a complete molar pregnancy. But they are not as good at picking up partial molar pregnancies. […] If you’ve had a miscarriage in hospital or an abortion, a doctor usually examines the placental and foetal tissue in the laboratory. These checks can pick up the abnormal cells of a molar pregnancy. […] Your healthcare team will tell you if they see a molar pregnancy. This can be a shock and can be very upsetting. […] You will need to have treatment to remove the molar pregnancy from the womb.

• #1 Molar Pregnancy: Types, Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17889-molar-pregnancy

  A molar pregnancy occurs when an egg and sperm join incorrectly at fertilization and create a noncancerous tumor. […] Your healthcare provider diagnoses a molar pregnancy during routine prenatal tests (usually in the first trimester). An ultrasound of your uterus often shows several fluid-filled sacs instead of a placenta. […] Your provider can also measure HCG levels in your blood. A healthy placenta produces HCG during pregnancy. […] In molar pregnancies, HCG is produced at abnormally high levels. A blood test can detect these high levels and suggest a molar pregnancy has occurred. […] A molar pregnancy must be removed from your body or it can cause serious complications. […] People generally require surgical treatment to remove molar pregnancies. […] Your healthcare provider will monitor your HCG levels until levels return to normal. This ensures all the molar tissue is gone.

• #1 Diagnosis and Management of Molar Gestation

  https://www.exxcellence.org/list-of-pearls/diagnosis-and-management-of-molar-gestation/?categoryName=&searchTerms=&featured=False&bookmarked=False&sortColumn=date&sortDirection=Descending

  Molar gestation arises from villous trophoblasts in the setting of aberrant fertilization. Molar gestation comprises 2 distinct subtypes: complete moles and partial moles. Unregulated trophoblastic proliferation causes elevated concentrations of human chorionic gonadotropin (hCG), commonly exceeding 100,000 IU/L in complete moles. While the initial management is the same for both subtypes, distinguishing between the entities is critical because the risk of medical complications and development of postmolar GTN is significantly higher for complete moles (20% vs 4%). […] However, with the increased use of ultrasonography in early pregnancy, most moles are diagnosed incidentally in the first trimester due to bleeding and/or elevated hCG. Ultrasound findings of a multicystic mass filling the uterus and theca lutein cysts are classic for complete moles, A placenta with focal cystic changes and a nonviable fetus are suggestive of a partial mole.

• #1 Molar pregnancy – WikEM

  https://wikem.org/wiki/Molar_pregnancy

  Due primarily to elevated levels of hCG. […] Serum hCG 100,000 mIU/mL suggest excessive trophoblastic growth. […] Normal hCG level does not exclude molar pregnancy. […] Partial molar pregnancies are more likely to produce lower hCG levels. […] Pelvic ultrasound: Complete mole – enlarged uterus with interspersed lucent and brighter areas („snowstorm” appearance). […] Before 12 weeks, may show a fine vascular or honeycomb appearance. […] Partial mole – more difficult to diagnose, with the fetus possibly being viable.

• #1 Molar Pregnancy: Symptoms, Causes, Treatment, Pictures, and More

  https://www.healthline.com/health/pregnancy/molar-pregnancy

  High levels of hCG in the blood might also be a sign of a molar pregnancy. But some molar pregnancies may not raise hCG levels and high hCG is also caused by other standard kinds of pregnancies, like carrying twins. In other words, your doctor won’t diagnose a molar pregnancy based on hCG levels alone.

• #1 Molar pregnancy – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/diagnosis-treatment/drc-20375180

  A continuing high level of HCG in the blood might require more treatment. […] After treatment for the molar pregnancy is complete, a provider might check HCG levels for six months to make sure no molar tissue is left. […] For people with GTN, HCG levels are checked for one year after chemotherapy is completed. […] Because pregnancy HCG levels also increase during a regular pregnancy, a provider might recommend waiting 6 to 12 months before trying to become pregnant again.

• #1 Hydatidiform Mole – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459155/

  A hydatidiform mole, or molar pregnancy, is a rare abnormal pregnancy classified under gestational trophoblastic diseases that originate in the placenta and may spread to other areas. […] Diagnosis is confirmed through histopathological examination after tissue removal. […] Ultrasound typically reveals anechoic cystic clusters for complete moles and fetal tissue for partial moles. […] Histopathological examination postevacuation confirms the diagnosis with visualization of characteristic villous changes. […] In a complete molar pregnancy, ultrasonography reveals anechoic cystic spaces resembling grape clusters with an echogenic mass and snowstorm appearance. […] Nevertheless, the definitive diagnosis can be only made by histopathological examination of the tissue postoperatively, where complete moles exhibit edematous hydropic villi with circumferential and hyperplastic trophoblastic cells and partial moles exhibit large hydropic villi and small fibrotic villi. […] Comprehension of the histological and genetic distinguishing characteristics between complete and partial moles is pivotal to accurate diagnosis and appropriate management.

• #1 Gestational Trophoblastic Disease | Choose the Right Test

  https://arupconsult.com/content/gestational-trophoblastic-disease

  Hydatidiform moles result in greatly increased production of hCG, and hCG testing should be performed when a molar pregnancy is suspected and may help differentiate between a PHM and a CHM. […] When a suspected molar pregnancy has been evacuated, flow cytometry or microsatellite short tandem repeat (STR) genotyping may be performed on the tissue to determine ploidy status and parental contribution to differentiate among CHMs, PHMs, and nonmolar pregnancies. […] Kinase inhibitor p57 is a gene that is paternally coded and maternally expressed and is thus absent in tissue from a CHM. […] hCG is the primary marker used during surveillance for, diagnosis of, and treatment monitoring in GTN. […] Surveillance for GTN should occur following a molar pregnancy. hCG concentrations should be measured regularly until normalization or diagnosis of GTN.

• #1 Hydatidiform Mole: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/254657-overview

  A hydatidiform mole (molar pregnancy) is a gestational trophoblastic disease. Ultrasonography is used to identify both complete and partial molar pregnancies. Treatment consists of evacuation of the uterus by dilation and curettage. […] The following laboratory studies may be used to evaluate patients with suspected hydatidiform mole: Quantitative beta-human chorionic gonadotropin (hCG) levels, Complete blood cell count with platelets, Clotting function studies, Liver function tests, Blood urea nitrogen (BUN) and serum creatinine levels, Blood type and Rh factor, Thyroxine level, Serum inhibin A and activin A levels. […] Ultrasonography is the criterion standard for identifying both complete and partial molar pregnancies. […] Evacuation of the uterus by dilation and curettage is always necessary.

• #1 Molar Pregnancy: Symptoms, Causes, & Treatments

  https://www.webmd.com/baby/what-is-molar-pregnancy

  You might find out you have a molar pregnancy during a routine ultrasound test. Your doctor could detect a problem through a blood test that shows your hCG levels are much higher than they should be. Or you might not know until you have a miscarriage. […] An ultrasound is a device that uses sound waves to look inside your uterus. You might have a transvaginal ultrasound, in which your doctor places a wandlike device in your vagina to create the image. […] If your doctor finds you have a molar pregnancy, they may do further imaging tests, such as a CT scan or MRI, to see if the tumor has spread to other parts of your body.

• #1 Hydatidiform Mole Workup: Laboratory Studies, Imaging Studies, Histologic Findings

  https://emedicine.medscape.com/article/254657-workup

  The following laboratory studies may be used to evaluate patients with suspected hydatidiform mole: […] Quantitative beta-hCG levels: hCG levels greater than 100,000 mIU/mL indicate exuberant trophoblastic growth and raise suspicion for a molar pregnancy. However, a molar pregnancy may have a normal hCG level. […] Ultrasonography is the criterion standard for identifying both complete and partial molar pregnancies. The classic image, using older ultrasonographic technology, is of a snowstorm pattern representing the hydropic chorionic villi. High-resolution ultrasonography shows a complex intrauterine mass containing many small cysts. […] Once a molar pregnancy is diagnosed, a baseline chest radiograph should be taken. The lungs are a primary site of metastasis for malignant trophoblastic tumors.

• #1 Diagnosis and Management of Molar Gestation

  https://www.exxcellence.org/list-of-pearls/diagnosis-and-management-of-molar-gestation/?categoryName=&searchTerms=&featured=False&bookmarked=False&sortColumn=date&sortDirection=Descending

  Suspected molar gestation should be managed surgically and expeditiously. Medical evacuation is discouraged because of high rates of failure and hemorrhage and increased risk of postmolar GTN. Hysterectomy is an appropriate alternative in patients who do not desire uterine preservation or who have risk factors for GTN, and this approach can reduce the risk of postmolar GTN by 80%. Uterine contents should be sent for histopathologic examination. […] The risk of postmolar GTN is greatest in the first year, and patients should undergo surveillance with serial hCG measurement using an assay that can detect all forms of this hormone. The Society of Gynecologic Oncology recommends checking hCG levels weekly until normalization, and then monthly for 3 months after complete moles and 1 month after partial moles. […] Risk factors for GTN include an hCG concentration at diagnosis greater than 100,000 IU/L, excessive uterine size, theca lutein cysts, and age older than 40 years. Despite earlier diagnosis of molar gestation, the incidence of postmolar GTN has remained constant.

• #1 Gestational Trophoblastic Disease | Choose the Right Test

  https://arupconsult.com/content/gestational-trophoblastic-disease

  Although histology or radiology may lead to a diagnosis of GTN, it is more often diagnosed solely based on hCG levels; histologic confirmation is not required. […] hCG levels can be used to diagnose GTN in the following situations: hCG levels plateau (i.e., do not increase or decrease by 10%) for four consecutive tests during a period of 3 weeks; hCG levels rise 10% for three consecutive tests during a period of 2 weeks. […] Treatment response for GTN should be monitored by performing hCG testing either weekly or on day 1 of each chemotherapy cycle.

• #1 Molar pregnancy: The next steps after diagnosis | MDedge

  https://blogs.the-hospitalist.org/content/molar-pregnancy-next-steps-after-diagnosis

  Typically after evacuation of a molar pregnancy, there is rapid fall in hCG levels, but this does not occur when the molar pregnancy has become invasive or is associated with choriocarcinoma. In these cases, after an initial drop in hCG levels, there is an observed rise or plateau in levels, and this establishes the diagnosis of postmolar GTN. […] Once postmolar GTN has been diagnosed, it is most appropriate to refer the patient to a gynecologic oncologist with experience in the treatment of these relatively rare malignancies. At that point, the patient will be formally staged, and offered treatment based on these staging results. […] Postmolar GTN is a serious condition that usually can be cured with chemotherapy or, if appropriate, surgery. Gynecologists should be vigilant for the development of postmolar GTN following evacuation of a molar pregnancy, and refer to a gynecologic oncologist when criteria are met to ensure that overtreatment is avoided and essential therapy is ensured.

• #1 Information about molar pregnancy | Imperial College Healthcare NHS Trust

  https://www.imperial.nhs.uk/our-services/cancer-services/gestational-trophoblastic-disease/information-about-molar-pregnancy

  The most frequent choice is chemotherapy. This approach is usually very simple, generally has few side effects, allows patients to retain their fertility and has a cure rate of over 99 per cent. […] Chemotherapy is continued until the hCG level reaches normal and then for a further six weeks after that to kill off any residual cells. […] Women who have had one molar pregnancy do have an increased risk of developing another molar pregnancy in their next pregnancy. However this risk is still quite low: we would estimate it at around one in 100.

• #1 Molar Pregnancy: Symptoms, Risks & Treatment [2023 Updated]

  https://americanpregnancy.org/healthy-pregnancy/birth-defects/molar-pregnancy/

  Molar pregnancy is an abnormality of the placenta, caused by a problem when the egg and sperm join together at fertilization. […] A pelvic exam may reveal a larger or smaller uterus, enlarged ovaries, and abnormally high amounts of the pregnancy hormone hCG. […] A sonogram will often show a “cluster of grapes” appearance, signifying an abnormal placenta. […] Molar pregnancies are removed by suction curettage, dilation, and evacuation (D & C), or sometimes through medication. […] Approximately 90% of women who have a mole removed require no further treatment. […] Follow-up procedures that monitor the hCG levels can occur monthly for six months or as your physician prescribes. […] Follow-up is done to ensure that the mole has been removed completely. […] Women should avoid becoming pregnant for one year after diagnosis. […] If you had a molar pregnancy without complications, your risk of having another molar pregnancy is about 1-2%.

• #1 Molar pregnancy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/symptoms-causes/syc-20375175

  A molar pregnancy requires early treatment. […] Because of improved ways of detecting a molar pregnancy, most are found in the first trimester. […] One sign of persistent GTN is a high level of human chorionic gonadotropin (HCG) a pregnancy hormone after the molar pregnancy has been removed. […] Persistent GTN is usually treated with chemotherapy. […] A complete molar pregnancy is more likely to have this complication than is a partial molar pregnancy. […] If you’ve had a molar pregnancy, talk to your pregnancy care provider before trying to get pregnant again. […] During future pregnancies, a care provider may do early ultrasounds to check your condition and make sure the baby is developing.

• #1 Advances in the diagnosis and early management of gestational trophoblastic disease | BMJ Medicine

  https://bmjmedicine.bmj.com/content/1/1/e000321

  Gestational trophoblastic disease describes a group of rare pregnancy related disorders that span a spectrum of premalignant and malignant conditions. Hydatidiform mole (also termed molar pregnancy) is the most common form of this disease. […] Hydatidiform mole typically presents in the first trimester with irregular vaginal bleeding and can be suspected on ultrasound but confirmation requires histopathological evaluation of the products of conception. […] Close monitoring of women after molar pregnancy, with regular measurement of human chorionic gonadotrophin concentrations, allows for early detection of malignancy. […] The diagnosis of GTN is largely based on a combination of obstetric history and elevated concentrations of hCG. […] After molar pregnancy, plateaued or rising hCG concentrations are indicative of GTN.

• #1 Molar Pregnancy: Types, Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17889-molar-pregnancy

  Most people who receive treatment for a molar pregnancy have no further complications. […] If you have a molar pregnancy, your risk for miscarriage doesn’t increase. […] A molar pregnancy usually results in the loss of the pregnancy. […] If you’re pregnant and experiencing vaginal bleeding, severe nausea and vomiting, or passing grape-like cysts from your vagina, contact your pregnancy care provider immediately.

• #2 Diagnosis and Management of Molar Gestation

  https://www.exxcellence.org/list-of-pearls/diagnosis-and-management-of-molar-gestation/?categoryName=&searchTerms=&featured=False&bookmarked=False&sortColumn=date&sortDirection=Descending

  Molar gestation arises from villous trophoblasts in the setting of aberrant fertilization. Molar gestation comprises 2 distinct subtypes: complete moles and partial moles. Unregulated trophoblastic proliferation causes elevated concentrations of human chorionic gonadotropin (hCG), commonly exceeding 100,000 IU/L in complete moles. While the initial management is the same for both subtypes, distinguishing between the entities is critical because the risk of medical complications and development of postmolar GTN is significantly higher for complete moles (20% vs 4%). […] However, with the increased use of ultrasonography in early pregnancy, most moles are diagnosed incidentally in the first trimester due to bleeding and/or elevated hCG. Ultrasound findings of a multicystic mass filling the uterus and theca lutein cysts are classic for complete moles, A placenta with focal cystic changes and a nonviable fetus are suggestive of a partial mole.

• #2 Diagnosing molar pregnancy | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/gestational-trophoblastic-disease-gtd/molar-pregnancy/diagnosing-molar-pregnancy

  Molar pregnancy is usually diagnosed during routine pregnancy tests and scans. […] Measuring the levels of hCG in your blood and urine can help to diagnose a molar pregnancy. […] Pelvic ultrasound scans are a good way of diagnosing a complete molar pregnancy. But they are not as good at picking up partial molar pregnancies. […] If you’ve had a miscarriage in hospital or an abortion, a doctor usually examines the placental and foetal tissue in the laboratory. These checks can pick up the abnormal cells of a molar pregnancy. […] Your healthcare team will tell you if they see a molar pregnancy. This can be a shock and can be very upsetting. […] You will need to have treatment to remove the molar pregnancy from the womb.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-Molar-Pregnancy.aspx

  A molar pregnancy is often completely asymptomatic, and the diagnosis is made only when the first pregnancy scan routinely scheduled at 10 to 14 weeks reveals the problem. […] A pelvic ultrasound scan will show the presence of tissue inside the uterus, with the characteristic snowstorm appearance of a molar pregnancy. […] When a patient presents with early pregnancy bleeding or other abnormal pregnancy features, an ultrasound scan is usually recommended. This may show the characteristic features of a hydatidiform mole. […] When the ultrasound does not provide characteristic features of molar pregnancy, or looks like a miscarriage, the woman may be advised to have her hCG levels checked as well to differentiate between several possible diagnoses. […] Ultrasound scanning shows a honeycomb pattern produced by the numerous vesicles. As they enlarge the image is described to look like a snowstorm, which is due to swollen cysts with bleeding into the uterus. […] If the diagnosis is in doubt, a repeat scan is ordered after a week or two. In almost all partial moles the fetus is aborted spontaneously, and the diagnosis is established by microscopic examination and cytogenetic study of the aborted tissue.

• #2 Partial Molar Pregnancy: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12332-partial-molar-pregnancy

  A partial molar pregnancy is a type of molar pregnancy where the embryo (fertilized egg) has too many chromosomes. This happens when the egg gets 69 chromosomes instead of 46. In a molar pregnancy, the embryo either develops incompletely or doesn’t develop at all. Partial molar pregnancies require immediate medical attention. […] A partial molar pregnancy is diagnosed by performing an ultrasound. An ultrasound may show no fetus or a fetus that appears small. A placenta that appears filled with cysts or looks unusual. They’ll also order blood tests that measure the levels of human chorionic gonadotropin (HCG). In a partial molar pregnancy, the HCG levels rise at a faster rate and often to a higher level than a normal pregnancy. […] Your healthcare provider will treat a partial molar pregnancy by removing the fetus and placenta from your uterus. This is known as a dilation and curettage (DC). After this procedure, your provider may continue to measure your HCG levels for up to one year to determine if there are any remnants of the molar tissue in your uterus.

• #2 Diagnosis at a Glance: Partial Hydatidiform Molar Pregnancy | MDedge

  https://mdedge.com/emed-journal/article/129144/obstetrics/diagnosis-glance-partial-hydatidiform-molar-pregnancy

  However, due to the heterogeneous appearance of the uterus in all GTD, molar pregnancies can sometimes be misinterpreted as missed abortions or clotted blood, so that pathological confirmation is mandatory for all products of conception in the United States and Canada. […] The ED bedside ultrasound findings did demonstrate the characteristic “cluster of grapes” appearance surrounded by the hyperechoic appearance of the spiral arteries. An intrauterine yolk sac was also identified by ultrasound, which strongly suggested a partial rather than a complete hydatidiform molar pregnancy.

• #2 Hydatidiform Mole Workup: Laboratory Studies, Imaging Studies, Histologic Findings

  https://emedicine.medscape.com/article/254657-workup

  The following laboratory studies may be used to evaluate patients with suspected hydatidiform mole: […] Quantitative beta-hCG levels: hCG levels greater than 100,000 mIU/mL indicate exuberant trophoblastic growth and raise suspicion for a molar pregnancy. However, a molar pregnancy may have a normal hCG level. […] Ultrasonography is the criterion standard for identifying both complete and partial molar pregnancies. The classic image, using older ultrasonographic technology, is of a snowstorm pattern representing the hydropic chorionic villi. High-resolution ultrasonography shows a complex intrauterine mass containing many small cysts. […] Once a molar pregnancy is diagnosed, a baseline chest radiograph should be taken. The lungs are a primary site of metastasis for malignant trophoblastic tumors.

• #2 Molar Pregnancy: Types, Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17889-molar-pregnancy

  A molar pregnancy occurs when an egg and sperm join incorrectly at fertilization and create a noncancerous tumor. […] Your healthcare provider diagnoses a molar pregnancy during routine prenatal tests (usually in the first trimester). An ultrasound of your uterus often shows several fluid-filled sacs instead of a placenta. […] Your provider can also measure HCG levels in your blood. A healthy placenta produces HCG during pregnancy. […] In molar pregnancies, HCG is produced at abnormally high levels. A blood test can detect these high levels and suggest a molar pregnancy has occurred. […] A molar pregnancy must be removed from your body or it can cause serious complications. […] People generally require surgical treatment to remove molar pregnancies. […] Your healthcare provider will monitor your HCG levels until levels return to normal. This ensures all the molar tissue is gone.

• #2 Molar pregnancy | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/molar-pregnancy

  Molar pregnancy is usually diagnosed early in pregnancy due to bleeding, abnormal features in ultrasound scan and higher than usual levels of the pregnancy hormone, hCG. […] A molar pregnancy can only be confirmed when the pregnancy tissue is examined under a microscope by a pathologist. This not always possible as tissue is not always sent to a laboratory for testing after a miscarriage or a normal pregnancy, labour and birth. […] In addition to laboratory testing of pregnancy tissue, there can be signs suggestive of a molar pregnancy: Vaginal bleeding not related to menstruation, or prolonged after birth. […] Ultrasound abnormalities including abnormal appearance of the uterine cavity or ovarian cysts. […] Abnormally high levels of the pregnancy hCG hormone and associated consequences including severe nausea (morning sickness) and high blood pressure (which can lead to preeclampsia).

• #2 Gestational Trophoblastic Disease | Doctor

  https://patient.info/doctor/gestational-trophoblastic-disease

  Features of a partial molar pregnancy include: presence of fetal tissue; focal hydropic change to the villi; and some excess trophoblast proliferation. Ploidy status and immunohistochemistry staining for p57, a paternally imprinted gene, may help in distinguishing partial from complete molar pregnancies. […] The histological assessment of material obtained from the medical or surgical management of all miscarriages is recommended to exclude trophoblastic neoplasia if no fetal parts are identified at any stage of the pregnancy. […] The use of ultrasound in early pregnancy has led to the earlier diagnosis of molar pregnancy.

• #2 Diagnosis at a Glance: Partial Hydatidiform Molar Pregnancy | MDedge

  https://mdedge.com/emed-journal/article/129144/obstetrics/diagnosis-glance-partial-hydatidiform-molar-pregnancy

  A bedside ultrasound, performed by an ultrasound-trained emergency physician (EP), was noted to demonstrate a complex intrauterine mass comprised of several small, rounded anechoic clusters. […] No definitive ultrasonographic signs of an intrauterine pregnancy were seen. A consultative radiology ultrasound was subsequently ordered, which confirmed the likelihood of a partial molar pregnancy. […] The products of conception were sent to pathology, and confirmed a triploid karyotype and p57 trophoblastic immunopositivity, diagnostic of a partial hydatidiform mole. […] According to the American College of Radiology’s Appropriateness Criteria, ultrasound is the gold standard for evaluating gestational trophoblastic disease. […] While the classic sonographic appearance of a molar pregnancy is described as a “snowstorm” appearance, advancement in technology more clearly demonstrates a “cluster of grapes” or “honeycomb” appearance.

• #2 Molar Pregnancy Symptoms and Treatment Options

  https://www.verywellhealth.com/molar-pregnancy-5115690

  If your healthcare provider suspects a molar pregnancy, a transvaginal ultrasound can usually confirm a diagnosis, especially if the mole is complete. An ultrasound image of a mole often appears like a clump of grapes or a honeycomb. […] Further testing may be recommended in order to determine what type of mole you have and whether it has spread to other parts of the body. These tests might include: X-rays, Computed tomography (CT scans), Magnetic resonance imaging (MRI) to view your chest, head, and abdomen.

• #2 Molar pregnancy: The next steps after diagnosis | MDedge

  https://blogs.the-hospitalist.org/content/molar-pregnancy-next-steps-after-diagnosis

  After evacuation of a molar pregnancy, gynecologists should be on alert for the development of postmolar GTN if the following known risk factors are present: a history of a prior GTN diagnosis, complete mole on pathology (as opposed to partial mole), serum human chorionic gonadotropin (hCG) levels greater than 100,000 mIU/mL, age greater than 40 years, an enlarged uterus or large ovarian theca lutein cysts, and slow to normalize (more than 2 months) hCG. Symptoms for the development of postmolar GTN include persistent vaginal bleeding after evacuation, a persistently enlarged or enlarging uterine size, and adnexal masses. Ultimately, the diagnosis is made through plateaued or rising serum hCG assessments. […] Following the evacuation of a molar pregnancy, hCG levels should be drawn at the same laboratory every 1-2 weeks until normalization and then three consecutive normal values. Once this has been achieved, hCG levels should be tested once at 3 months and again at 6 months.

• #2 Information about molar pregnancy | Imperial College Healthcare NHS Trust

  https://www.imperial.nhs.uk/our-services/cancer-services/gestational-trophoblastic-disease/information-about-molar-pregnancy

  All women in the UK who have had a molar pregnancy are enrolled in a national follow-up programme, where their levels of hCG are monitored. […] Following confirmation on review at Charing Cross, follow up begins with serum and urine tests every two weeks until hCG levels are normal. […] In most patients no further treatment is needed after the evacuation and the monitoring centre watches the hCG level fall back to normal and stay there. However, in approximately 10 per cent of patients who have had a complete molar pregnancy and one per cent of partial mole patients, treatment is needed. […] The decision to start treatment is generally made on the pattern of the hCG levels following the evacuation. […] Chemotherapy is drug treatment which is used to kill the trophoblastic cells that are still trying to grow.

• #2 Advances in the diagnosis and early management of gestational trophoblastic disease | BMJ Medicine

  https://bmjmedicine.bmj.com/content/1/1/e000321

  Obstetric management of molar pregnancy involves uterine evacuation and histopathological examination of the products of conception. […] Follow-up serum or urine hCG monitoring is done until hCG values return to within the normal range. […] Most women with molar pregnancy do not require further treatment following uterine evacuation of the products of conception. However, some women develop disease persistence and progress to malignant disease requiring chemotherapy or further surgical intervention. […] The diagnosis of CHM, PHM, placental site nodule, and atypical placental site nodule is made on the basis of histopathological confirmation. […] In contrast, diagnosis of GTN does not usually rely on histopathological confirmation as biopsies are not always available. […] The treatment of invasive mole and choriocarcinoma is often initiated on the basis of a rising hCG level even in the absence of other clinical evidence of disease recurrence. […] Importantly, all guidelines recommend that GTN should be considered in the differential diagnosis of all women who present with irregular vaginal bleeding after pregnancy and that serum hCG measurement should be included in the diagnostic investigations.

• #2 Molar pregnancy and gestational trophoblastic disease | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/molar-pregnancy-and-gestational-trophoblastic-disease/

  Follow-up involves measuring the pregnancy hormone hCG, either in your blood or your urine, until it returns to normal. […] Continuing with this specialist follow-up is important as it is very successful in treating GTD (98100% cure rate) and there are very low rates of progression to more serious forms of GTD. […] A molar pregnancy can be thought of as a precancerous illness which can occasionally progress to GTN. […] GTN usually happens when molar pregnancy cells keep growing in your uterus. […] If you are diagnosed with GTN, you will usually need to have further treatment. […] Treatment is continued until 6 weeks after your hCG level has returned to normal. […] Having a molar pregnancy does not affect your chance of having another baby. […] The risk of a molar pregnancy happening again is low. For 99 out of 100 women their next pregnancy will not be a molar pregnancy.

• #2 FAQs – Charing Cross Gestational Trophoblast Disease Service

  https://www.hmole-chorio.org.uk/frequently-asked-questions/

  In the UK all cases of molar pregnancy should be registered for hCG (pregnancy test hormone) based follow-up. […] In all cases of molar pregnancy and the other forms of trophoblastic disease the hCG level is important for making the diagnosis and for monitoring treatment. […] A molar pregnancy on its own is not a form of cancer. […] The decision to start treatment is generally made on the pattern of the hCG levels following the evacuation. […] There are three treatment options for patients with persistent trophoblastic disease after a molar pregnancy. […] Chemotherapy is treatment with drugs to kill the trophoblastic cells that are still trying to grow. […] Chemotherapy is continued until the hCG level reaches normal and then for a further 6 weeks after that to kill off any residual cells. […] Women who have had one molar pregnancy do have an increased risk of developing another molar pregnancy when they are next pregnant.

• #2 Molar Pregnancy: Symptoms, Risks & Treatment [2023 Updated]

  https://americanpregnancy.org/healthy-pregnancy/birth-defects/molar-pregnancy/

  Molar pregnancy is an abnormality of the placenta, caused by a problem when the egg and sperm join together at fertilization. […] A pelvic exam may reveal a larger or smaller uterus, enlarged ovaries, and abnormally high amounts of the pregnancy hormone hCG. […] A sonogram will often show a “cluster of grapes” appearance, signifying an abnormal placenta. […] Molar pregnancies are removed by suction curettage, dilation, and evacuation (D & C), or sometimes through medication. […] Approximately 90% of women who have a mole removed require no further treatment. […] Follow-up procedures that monitor the hCG levels can occur monthly for six months or as your physician prescribes. […] Follow-up is done to ensure that the mole has been removed completely. […] Women should avoid becoming pregnant for one year after diagnosis. […] If you had a molar pregnancy without complications, your risk of having another molar pregnancy is about 1-2%.

• #2 Molar pregnancy – Leeds Teaching Hospitals NHS Trust

  https://www.leedsth.nhs.uk/services/gynaecology/gatu/early-pregnancy/molar-pregnancy/

  The pregnancy tissue is removed from your uterus and sent to the pathology laboratory to check the diagnosis. […] This option is not recommended when a molar pregnancy is suspected. […] If you are confirmed to have a molar pregnancy we recommend that you are entered into a specialist follow up programme. […] The specialist centre is the Trophoblastic Screening and Treatment Centre at Weston Park Hospital in Sheffield. […] Even when your pregnancy hormone levels fall back to normal you will be asked not to get pregnant and to continue being monitored through Weston Park Hospital for at least six months. […] 1 in 20 women with complete molar pregnancy need to have further investigations and possibly chemotherapy. […] It is usually diagnosed if your HCG levels do not return to normal which is why follow-up is so important.

• #2 Information about molar pregnancy | Imperial College Healthcare NHS Trust

  https://www.imperial.nhs.uk/our-services/cancer-services/gestational-trophoblastic-disease/information-about-molar-pregnancy

  The most frequent choice is chemotherapy. This approach is usually very simple, generally has few side effects, allows patients to retain their fertility and has a cure rate of over 99 per cent. […] Chemotherapy is continued until the hCG level reaches normal and then for a further six weeks after that to kill off any residual cells. […] Women who have had one molar pregnancy do have an increased risk of developing another molar pregnancy in their next pregnancy. However this risk is still quite low: we would estimate it at around one in 100.

• #3 Molar Pregnancy: Symptoms, Causes, Treatment, Pictures, and More

  https://www.healthline.com/health/pregnancy/molar-pregnancy

  A molar pregnancy occurs when the placenta doesn’t develop normally. Instead, a tumor forms in the uterus and causes the placenta to become a mass of fluid-filled sacs, also called cysts. […] A molar pregnancy is also called a mole, a hydatidiform mole, or gestational trophoblastic disease. […] A molar pregnancy may feel just like a typical pregnancy at first. However, you’ll likely have certain signs and symptoms that something is different. […] Sometimes a molar pregnancy is diagnosed when you go for your usual pregnancy ultrasound scan. Other times, your doctor will prescribe blood tests and scans if you have symptoms that might be caused by a molar pregnancy. […] A pelvis ultrasound of a molar pregnancy will typically show a grape-like cluster of blood vessels and tissue. Your doctor may also recommend other imaging like MRI and CT scans to confirm the diagnosis.

• #3 Molar pregnancy: The next steps after diagnosis | MDedge

  https://blogs.the-hospitalist.org/content/molar-pregnancy-next-steps-after-diagnosis

  After evacuation of a molar pregnancy, gynecologists should be on alert for the development of postmolar GTN if the following known risk factors are present: a history of a prior GTN diagnosis, complete mole on pathology (as opposed to partial mole), serum human chorionic gonadotropin (hCG) levels greater than 100,000 mIU/mL, age greater than 40 years, an enlarged uterus or large ovarian theca lutein cysts, and slow to normalize (more than 2 months) hCG. Symptoms for the development of postmolar GTN include persistent vaginal bleeding after evacuation, a persistently enlarged or enlarging uterine size, and adnexal masses. Ultimately, the diagnosis is made through plateaued or rising serum hCG assessments. […] Following the evacuation of a molar pregnancy, hCG levels should be drawn at the same laboratory every 1-2 weeks until normalization and then three consecutive normal values. Once this has been achieved, hCG levels should be tested once at 3 months and again at 6 months.

• #3 Partial Molar Pregnancy: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12332-partial-molar-pregnancy

  A partial molar pregnancy is a type of molar pregnancy where the embryo (fertilized egg) has too many chromosomes. This happens when the egg gets 69 chromosomes instead of 46. In a molar pregnancy, the embryo either develops incompletely or doesn’t develop at all. Partial molar pregnancies require immediate medical attention. […] A partial molar pregnancy is diagnosed by performing an ultrasound. An ultrasound may show no fetus or a fetus that appears small. A placenta that appears filled with cysts or looks unusual. They’ll also order blood tests that measure the levels of human chorionic gonadotropin (HCG). In a partial molar pregnancy, the HCG levels rise at a faster rate and often to a higher level than a normal pregnancy. […] Your healthcare provider will treat a partial molar pregnancy by removing the fetus and placenta from your uterus. This is known as a dilation and curettage (DC). After this procedure, your provider may continue to measure your HCG levels for up to one year to determine if there are any remnants of the molar tissue in your uterus.

• #3 Partial Molar Pregnancy: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12332-partial-molar-pregnancy

  No, you can’t prevent a partial molar pregnancy (or a complete molar pregnancy). […] Yes. The odds of having another molar pregnancy are small (approximately 1% to 2%), but there’s still a risk. You should discuss the timing of a future pregnancy with your healthcare provider, as they may recommend a certain time frame. […] No, a fetus won’t survive a partial molar pregnancy. At most, the pregnancy tissue may continue to develop for about 12 weeks (three months).

Zobacz więcej