II. Introduction1.Definition of CaseA hydatidiform mole is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
is an abnormal form of pregnancy, characterized by the presence of ahydatidiform mole (or hydatid mole, mola hytadidosa). Molar pregnancy comprises twodistinct entities, partial and complete moles. Complete moles have no identifiableembryonic or fetal tissues and arise when an empty egg with no nucleus is fertilized by anormal sperm. In contrast, a partial mole occurs when a normal egg is fertilized by twospermatozoa. Hydatidiform moles may develop intochoriocarcinoma, a form of cancer.The etymology is derived from
(Greek "a drop of water"), referring to thewatery contents of the cysts, and
= millstone/false conception).The term, however, comes from the cyst's appearance looking very much like a hydatidcyst in anEchinococcosis.2. EtiologyPREDISPOSING FACTORSA. Diet: Low CHON and low Vitamin A (carotene) intake.B. Age: Women older than 35 years.1.Prior molar pregnancy2.Extremes of reproductive age1.Age under 20 years2.Age over 45 years3.Twin Gestation4.High parity5.MalnutritionGTD is higher toward the beginning and toward the end of child bearing period. Itis ten times more in women who are 45 years old and beyond.C. Race:C. Race: Asian heritage.Molar pregnancy has no racial or ethnic predilection, although Asian countries show arate 15 times higher than the US rate
3. Incidencea)North America and Europe: 1:1000 to 1:1500 pregnancies b)Asia and Latin America: 1:400 to 1:200 pregnanciesc)Philippines: 1:2504. General Signs and Sympotoms
a)Excessive Uterine enlargementa.Larger than expected for gestational age b)Fetus absenta.Fetal Heart Tonesabsent b.Absent fetal partsc)Ovarian enlargement (10%)a.Related to theca-lutein cystsd)OnsetHypertensionearly in pregnancya.Occurs beforePregnancy Induced Hypertension b.Occurs in first or second trimester e)preeclampsia develops in 20 – 30 % cases, usually before 20 weeks’ AOGf)pallor indicating anemia may be presentg)hyperthyroidism develops in 3-10% of cases manifested by enlarged thyroid glandand tachycardia (due to chorionic thyrotropin secreted by the trophoblast and hCGalso has a thyroid-sa)Vaginal Bleedingduring pregnancy in 3rd-4th month b)Hyperemesis Gravidarumc)Passage of grapelike villi from the uterusd)Abdominal Painearly in pregnancye)Pallor or Dyspneaa.Associated withAnemiaf)Anxiety andTremor a.Due to weak Thyroidstimulation by HCGg)Amenorrheah)Symptoms of pregnancy especially vomitingi)Symptoms of preeclampsia that may be present as headache and edema j)vaginal bleeding as the main complaint; due to the separation of vesicles from theuterine wall and there may be blood-stained, watery discharge (the watery part isfrom the ruptured vesicles)k)Blood may be concealed in the uterus, thereby causing enlargement.