Sonographic appearance of first trimester complete hydatidiform moles

Benson, Carol B.; Genest, David R.; Bernstein, Marilyn R.; Soto-Wright, Valena; Goldstein, Donald P.; Berkowitz, Ross S.

doi:10.1046/j.1469-0705.2000.00201.x

Cited by 125 publications

(70 citation statements)

References 9 publications

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“…Among 102 cases of GTD, range of parity was from 0 to 11 which was comparable (0 to 17) to a study by Fatima et al 10 In this study, most of the GTD cases presented as P/V bleeding (67.6%) which is similar to studies conducted by Fatima et al 10 and Hou et al 11 USG diagnosed cases of GTN in 29.4% and more than half of these,17/30 (56.6%) were diagnosed in first trimester, reflecting the diagnosis of disease by USG in early pregnancy. 12 The risk of GTN for complete HM (15-20%) is significantly higher than for partial HM (0.2-4%) [13][14][15][16] as was also noted in this study CHM (15.5%) and PHM (5.5%).…”

Section: Discussionsupporting

confidence: 51%

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Shakya¹,

Baral

2018

Nepal j. obstet. gynaecol.

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Aims:The objective of this study was to determine the clinical presentation of GTD and response of GTN to single and multiple agent chemotherapy on the basis of WHO Prognostic risk scoring system. Methods:This was a cross-sectional retrospective study undertaken at Paropakar Maternity and Women's Hospital. The medical records of 102 GTD cases were reviewed from January 25, 2015 to January 24, 2016. Data pertaining patient characteristics, histopathology types of GTD, management, prognostic risk scores, chemotherapy, follow up and remissions were retrieved and were analyzed using SPSS version 16.0.Results: Among 102 GTD cases, the most common presentation was vaginal bleeding 69(67.6%) followed by ultrasound diagnosed cases 30(29.4%). Primary management of all cases were suction evacuation, 68 completed and 12 are under follow-up. GTN was diagnosed in 14/90 (15.5%) of complete mole and 5/90 (5.5%) of partial mole. Twenty-two cases received chemotherapy for persistent gestational trophoblastic tumour(19) and invasive mole(3). Twenty cases were low risk score group and two cases under high risk group. Out of 20 low risk cases that received MTX-FA, 13/20 (65%) achieved remission. Due to low response of MTX-FA, five of them were converted to Actinomycin-D and achieved remission(100%). Two high risk cases received EMA-CO regimen and achieved 100% remission. Two low risk GTN, complete and invasive mole (underwent hysterectomy) are undergoing MTX-FA chemotherapy. Conclusions:The most common presentation of GTD was vaginal bleeding. Low risk GTN achieved 65% remission with Methotrexate-Folinic acid, ultimately achieved 100% remission with Actinomycin-D. High risk GTN achieved 100% remission with EMA-CO regimen.

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Section: Discussionsupporting

confidence: 51%

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Shakya¹,

Baral

2018

Nepal j. obstet. gynaecol.

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“…Only slightly more than half of first trimester molar pregnancies have a classical appearance; the rest may present as an anembryonic GS, incomplete abortion, or heterogeneously thick endometrium without the characteristic vesicular appearance. 69 Doppler examination of a CHM reveals increased uterine vascularity. High velocities with a low resistance index in the main and arcuate uterine arteries are characteristic of a molar pregnancy compared with the low velocities of a normal pregnancy.…”

Section: Hydatidiform Molementioning

confidence: 98%

Sonography in first trimester bleeding

Dighe

Cuevas

Moshiri

et al. 2008

J of Clinical Ultrasound

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Vaginal bleeding is the most common cause of presentation to the emergency department in the first trimester. Approximately half of patients with first trimester vaginal bleeding will lose the pregnancy. Clinical assessment is difficult, and sonography is necessary to determine if a normal fetus is present and alive and to exclude other causes of bleeding (eg, ectopic or molar pregnancy). Diagnosis of a normal intrauterine pregnancy not only helps the physician in terms of management but also gives psychologic relief to the patient. Improved ultrasound technology and high-frequency endovaginal transducers have enabled early diagnosis of abnormal and ectopic pregnancies, decreasing maternal morbidity and mortality. The main differential considerations of first trimester bleeding are spontaneous abortion, ectopic pregnancy, or gestational trophoblastic disease. This article reviews the causes of first trimester bleeding and the sonographic findings, including normal features of first trimester pregnancy.

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“…La evaluación rutinaria por ultrasonido pre-evacuación para la detección de mola hidatiforme tiene sensibilidad de 44% y especificidad de 74% 18,19 . Los hallazgos anatomo-patológicos de los especímenes revisados concuerdan con otras series donde prevalece la presencia de vellosidades hidrópicas, la decidua y el autolisado los cuales se presentaban en mayor forma en los especímenes quirúrgicos…”

Section: Materiales Y Métodosunclassified