A clinical, histopathological and flow cytometric study of 149 complete moles, 146 partial moles and 107 non‐molar hydropic abortions

Paradinas, F. J.; Browne, Patrick; Fisher, Rosemary A.; Foskett, Marianne; Bagshawe, K. D.; Newlands, E. S.

doi:10.1046/j.1365-2559.1996.247295.x

Cited by 144 publications

(87 citation statements)

References 7 publications

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Section: Introductionunclassified

“…

A hemorragia vaginal inicia-se, em geral, entre a 4ª e a 16ª semana de amenorréia, em mais de 95% das pacientes 5,6 .

…”

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“…A apresentação clínica da DTG tem tido frondosa descrição na literatura médica mundial [2][3][4] , exibindo sintomatologia exuberante: hemorragia genital, útero aumentado para a idade gestacional, hiperêmese gravídica, cistos tecaluteínicos dos ovários e toxemia precoce.A hemorragia vaginal inicia-se, em geral, entre a 4ª e a 16ª semana de amenorréia, em mais de 95% das pacientes 5,6 . Entre um e outro episódio hemorrágico elimina-se secreção serosa clara, de odor sanioso, decorrente da liquefação dos coágulos intra-uterinos.…”

unclassified

“…2 representadas por mola hidatiforme, mola invasora, coriocarcinoma e tumor trofoblástico do sítio placentário (PSTT), cujo espectro inclui formas benignas e malignas 1 . A apresentação clínica da DTG tem tido frondosa descrição na literatura médica mundial [2][3][4] , exibindo sintomatologia exuberante: hemorragia genital, útero aumentado para a idade gestacional, hiperêmese gravídica, cistos tecaluteínicos dos ovários e toxemia precoce.…”

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Mudanças na apresentação clínica da gravidez molar

Belfort¹,

Braga²

2004

Rev. Bras. Ginecol. Obstet.

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RESUMOObjetivo: determinar se a apresentação clínica da mola hidatiforme tem mudado nos últimos anos (1992)(1993)(1994)(1995)(1996)(1997)(1998) quando comparada a registros históricos de controle (1960-1981 (36,05; OR: 0,7; IC: 0,9); edema (12,05; OR: 0,5; IC: 0,8); e cistose ovariana (16,4 vs 41,05 OR: 0,3; IC: 0,4 representadas por mola hidatiforme, mola invasora, coriocarcinoma e tumor trofoblástico do sítio placentário (PSTT), cujo espectro inclui formas benignas e malignas 1 . A apresentação clínica da DTG tem tido frondosa descrição na literatura médica mundial [2][3][4] , exibindo sintomatologia exuberante: hemorragia genital, útero aumentado para a idade gestacional, hiperêmese gravídica, cistos tecaluteínicos dos ovários e toxemia precoce.A hemorragia vaginal inicia-se, em geral, entre a 4ª e a 16ª semana de amenorréia, em mais de 95% das pacientes 5,6 . Entre um e outro episódio hemorrágico elimina-se secreção serosa clara, de odor sanioso, decorrente da liquefação dos coágulos intra-uterinos. Quando o tamanho Introdução É a doença trofoblástica gestacional (DTG) contrafação reprodutiva cujas formas clínicas são

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Section: Introductionunclassified

“…

A hemorragia vaginal inicia-se, em geral, entre a 4ª e a 16ª semana de amenorréia, em mais de 95% das pacientes 5,6 .

…”

unclassified

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Mudanças na apresentação clínica da gravidez molar

Belfort¹,

Braga²

2004

Rev. Bras. Ginecol. Obstet.

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“…3,4 The reported incidences of subsequent development into gestational trophoblastic neoplasia requiring chemotherapy following complete and partial moles were quite variable, affected by the referral patterns, diagnostic criteria, and criteria for post-evacuation chemotherapy. 1,2,5,6 However, it is generally believed that such a risk is much higher after a complete mole when compared with a partial mole. The incidences of post-evacuation gestational trophoblastic neoplasia ranged from 8 to 29% in a complete mole and 0.5-5.5% in a partial mole.…”

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Analysis of gestational trophoblastic disease by genotyping and chromosome in situ hybridization

et al. 2003

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Hydatidiform mole is classified into partial and complete subtypes according to histopathological and genetic criteria. Distinction between the two by histology alone may be difficult. Genetically, a complete mole is diploid without maternal contribution, whereas a partial mole is triploid with a maternal chromosome complement. To assess the accuracy of histological diagnosis by correlating with the genetic composition, we performed fluorescent microsatellite genotyping to detect the presence or absence of maternal genome in a hydatidiform mole and carried out chromosome in situ hybridization to analyze the ploidy. For genotyping analysis, paraffin sections of 36 complete and nine partial moles, diagnosed according to histological criteria, were microdissected and DNA was separately extracted from the decidua and molar villi. Six pairs of primers that flank polymorphic microsatellite repeat sequences on five different chromosomes were used. In all, 34 cases, including 31 complete moles and three partial moles diagnosed histologically, showed no maternal contribution by genotyping; thus these could be genetically considered as complete mole. The other 11 cases (five complete moles and six partial moles previously diagnosed by histology) showed the presence of maternal contribution and were genetically diagnosed as partial moles. The genotyping results correlated with histological evaluation in 88% (37/45) of hydatidiform mole and correlated with chromosome in situ hybridization findings in all the cases, that is, triploid hydatidiform moles had maternal-derived alleles, while diploid hydatidiform moles were purely androgenetic. Compared with genetic diagnosis, histological evaluation was more reliable for the diagnosis of a complete mole (91%, 31/34) than that of a partial mole (55%, 6/11) (P ¼ 0.0033). Seven complete moles and three partial moles diagnosed genetically developed gestational trophoblastic neoplasia. To conclude, genotyping and chromosome in situ hybridization can provide reliable adjunct to histology for the classification of a hydatidiform mole, especially in cases with difficult histological evaluation and early gestational age. As a partial mole still carries a risk of developing gestational trophoblastic neoplasia, follow-up is considered necessary for both complete and partial moles.

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Early complete hydatidiform moles contain inner cell mass derivatives

et al. 1997

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In four cases of early complete hydatidiform moles, confirmed to be androgenetic in origin by DNA studies, we have identified nonchorionic inner cell mass derived structures which are not commonly observed in specimens of later gestational age. These structures include nucleated red blood cells, endothelial cells, stromal macrophages, amnion and yolk sac. The latter four structures were confirmed by specific immunocytochemical stains. Recognition that such structures can accompany complete hydatidiform moles has both theoretical and practical significance. From a theoretical perspective, it demonstrates that the maternal genome is not required for the initiation of amniogenesis, development of the yolk sac, vasculogenesis, or hematopoiesis. From a practical perspective it emphasizes that complete hydatidiform moles, with their markedly increased risk of subsequent choriocarcinoma, cannot be excluded based on the finding of "fetal structures."

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A clinical, histopathological and flow cytometric study of 149 complete moles, 146 partial moles and 107 non‐molar hydropic abortions

Cited by 144 publications

References 7 publications

Mudanças na apresentação clínica da gravidez molar

Mudanças na apresentação clínica da gravidez molar

Analysis of gestational trophoblastic disease by genotyping and chromosome in situ hybridization

Early complete hydatidiform moles contain inner cell mass derivatives

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