Mudanças na apresentação clínica da gravidez molar

Belfort, Paulo; Braga, Antônio

doi:10.1590/s0100-72032004000600010

Cited by 9 publications

(3 citation statements)

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“…In 15% to 25% of cases, the high concentration of hCG induces the formation of bulky ovarian theca lutein cysts, with more than 60 mm in diameter [21]. Early HDP is observed in 27% of complete HM and may end in eclampsia [22]. In addition, the HM can progress to full malignant forms of gestational trophoblastic disease in 20% of cases.…”

Section: Discussionmentioning

confidence: 99%

Hydatidiform mole resulting from sexual violence

Drezett¹,

Kurobe²,

Nobumoto³

et al. 2012

Int Arch Med

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BackgroundHydatidiform mole (HM) is characterized by abnormal proliferation of human trophoblast with producers functioning tissues of human chorionic gonadotropin. It can evolve with ovarian cysts tecaluteínicos, hypertension of pregnancy or hyperthyroidism. The incidence of HM is variable and its etiology poorly known, associated with nutritional factors, environmental, age, parity, history of HM, oral contraceptives, smoking, consanguinity or defects in germ cells. There is no reference in literature on HM resulting from sexual violence, objective of this report.MethodDescription of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital Pérola Byington, São Paulo, from July 1994 to August 2011.ResultsThe cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection.ConclusionThe incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition.

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Section: Discussionmentioning

confidence: 99%

Hydatidiform mole resulting from sexual violence

Drezett¹,

Kurobe²,

Nobumoto³

et al. 2012

Int Arch Med

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“…Accounting for 80% of all cases of GTD, hydatidiform mole reportedly occurs in 0.6-1.1/1000 pregnancies in North America ( 5 ) . It is estimated that hydatidiform mole occurs in 1/200-400 pregnancies in Brazil ( 6 ) , approximately 5-10 times more frequently than in North America and Europe ( 7 ) , perhaps reflecting differences in dietary or genetic influences.…”

Section: Epidemiology Of Gtdmentioning

confidence: 99%

“…The serum β-hCG level (typically > 100,000 mIU/mL) can vary greatly in normal and multiple pregnancies, as well as in molar pregnancy, and can therefore confound the diagnosis when considered in isolation ( 3 ) . Therefore, ultrasound is considered the principal method of diagnosing hydatidiform mole ( 1 , 6 , 11 ) .…”

Section: Epidemiology Of Gtdmentioning

confidence: 99%

Clinical and radiological correlations in patients with gestational trophoblastic disease

et al. 2016

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Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for regression, invasion, metastasis, and recurrence. In the past, it was common for patients with molar pregnancy to present with marked symptoms: copious bleeding; theca lutein cysts; uterus larger than appropriate for gestational age; early preeclampsia; hyperemesis gravidarum; and hyperthyroidism. Currently, with early diagnosis made by ultrasound, most patients are diagnosed while the disease is still in the asymptomatic phase. In cases of progression to trophoblastic neoplasia, staging-typically with Doppler flow studies of the pelvis and chest X-ray, although occasionally with computed tomography or magnetic resonance imaging-is critical to the choice of an appropriate antineoplastic therapy regimen. Because it is an unusual and serious disease that affects women of reproductive age, as well as because its appropriate treatment results in high cure rates, it is crucial that radiologists be familiar with gestational trophoblastic disease, in order to facilitate its early diagnosis and to ensure appropriate follow-up imaging.

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