Hydatidiform
Mole 葡萄胎
Hydatidiform moles categorised as either complete or partial moles.
Features of Complete and Partial Hydatidiform moles.
A. Complete Mole :
Fetal or embryonic tissue : Absent
Hydatidiform swelling of chorionic villi : Diffuse
Trophoblastic hyperplasia : Diffuse
Scalloping of chorionic villi : Absent
Trophoblastic stromal Inclusions : Absent
Karyotype : 46XX; 46XY
B. Partial Mole
Fetal or embryonic tissue : Present
Hydatidiform swelling of chorionic villi : Focal
Trophoblastic hyperplasia : Focal
Scalloping of chorionic villi : Present
Trophoblastic stromal Inclusions : Present
Karyotype : 69XXY; 69XYY
Diagnosis
1. Made on the basis of D & C.
2. Ultrasound: complete moles-a characteristic vesicular sonographic
pattern, "snowstorm" pattern; partial moles-focal cystic spaces in the
placental tissues and an increase in the transverse diameter of the
gestational sac.
Treatment and follow-up
1. Before evacuation, obtain the following laboratory studies: CBC, D/C,
PT, APTT, blood chemistries, including lirer function tests, blood type
and screen, and b–hCG; and CXR.
2. Evaluation of associated medical complications, including
preeclampsia, hypothyroidism, anemia, infection, electrolyte imbalance
and coagulopathy.
3. Suction curettage with oxytocin infusion.
4. Weekly serum b-hCG follow-up.
5. 3 consecutive weeks of undetectable serum b-hCG then monthly
determinations for at least half a year. |