Gynecology General Gynecology

Hydatidiform mole Wikipedia

merge|Molar pregnancy
DiseaseDisorder infobox |
Name = Hydatidiform mole |
ICD10 = O01, D39.2 |
ICD9 = 630 |

A hydatidiform mole (or mola hydatidiforma) is a disease of trophoblastic proliferation. It can mimic pregnancy, causes high human chorionic gonadotropin (HCG) levels and therefore gives false positive readings of pregnancy tests.

The cause is not completely understood. Potential causes may include defects in the egg, abnormalities within the uterus, or nutritional deficiencies. Women under 20 or over 40 years of age have a higher risk. Other risk factors include diets low in protein, folic acid, and carotene.

• vaginal discharge & bleeding

• Vaginal bleeding in pregnancy during the first trimester

hydatidiform mole can be of two types: complete or partial. A mole is characterized by a conceptus of hyperplasia|hyperplastic trophoblastic tissue attached to the placenta.

• Complete moles are diploid in nature and are purely paternal. Ninety percent are 46,XX, and 10% are 46,XY. This occurs when an empty ovum is fertilized by two sperms. This process is called androgenesis. There are no fetal parts. It carries risk of malignancy to choriocarcinoma.

For the complete mole, the anatomical appearance is like a bunch of grapes. Its DNA is purely paternal in origin. Less than 1% cases progress to choriocarcinoma.

For the partial mole, some fetal parts are seen.

Hydatidiform moles should be treated by evacuating the uterus by uterine suction or surgically as soon as possible after diagnosis. Patients are followed up until their serum human chorionic gonadotrophin (hCG) titre has fallen to an undetectable level. Invasive or metastatic moles often respond well to methotrexate.

More than 80% of hydatidiform moles are benign. The outcome after treatment is usually excellent. Close follow-up is essential. Highly effective means of contraception are recommended to avoid pregnancy for at least 6 to 12 months.

In 10 to 15% of cases, hydatidiform moles may develop into invasive moles. These may intrude so far into the uterine wall that hemorrhage or other complications develop.

In 2 to 3% of cases, hydatidiform moles may develop into choriocarcinoma, which is a malignant, rapidly- growing, and metastatic (spreading) form of cancer. Despite these factors which normally indicate a poor prognosis, the rate of cure after treatment with chemotherapy is high.

Over 90% of women with malignant, non-spreading cancer are able to survive and retain their ability to have children. In those with metastatic (spreading) cancer, remission remains at 75 to 85%, although the ability to have children is usually lost.

• Original source: http://www.nlm.nih.gov/medlineplus/ency/article/000909.htm

Last Modified:   2005-12-19