葡萄胎 Hydatidiform Mole
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.