The current clinical presentation of complete molar pregnancy

Gemer, Ofer; Segal, Shmuel; Kopmar, Alexander; Sassoon, Essi

doi:10.1007/pl00007481

Cited by 34 publications

(11 citation statements)

References 2 publications

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“…In the UK, most HM are now evacuated around 10 weeks of gestation 82. About half are entirely asymptomatic, detected as pregnancy failure following routine sonographic examination; the remainder present with vaginal bleeding 85. Analogous to the changing clinical and pathological aspects of HM, traditional sonographic presentations are also rarely seen.…”

Section: Specific Entitiesmentioning

confidence: 99%

Correlation of placental pathology with prenatal ultrasound findings

Sebire

Sepúlveda²

2008

J Clin Pathol

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There have been recent major advances in obstetric ultrasound, regarding both improved technologies and sonographer expertise, which have resulted in changes in antenatal obstetric management. The placenta is routinely examined to some extent at the time of the second trimester fetal anomaly sonogram, timing of delivery in pregnancies complicated by intrauterine growth restriction is primarily dependent on Doppler sonographic assessment of umbilical and uterine artery blood flow, and an increasing number of specific placental lesions have been described. Many non-specialist diagnostic histopathologists may be unfamiliar with these obstetric advances, but they are an increasingly common indication for submission of placentas for histological examination. Since the aims of pathological examination of the placenta are to determine the pathological basis for the clinical findings and advance understanding of the pathophysiology of pregnancy complications, this review therefore provides an overview of the most common prenatal sonographic techniques and their clinical relevance to the diagnostic pathologist, primarily focusing on conditions with specific placental implications. These range from abnormalities of placental site and cord insertion, to obstetric complications such as antepartum haemorrhage, through sonographic placental parenchymal lesions such as subchorionic and intervillous thrombi, or chorioangiomata. In addition, the pathophysiological basis of abnormal maternal and fetal maternal Doppler indices and intrauterine growth restriction are now described, being associated with decidual vasculopathy and villous changes associated with reduced intervillous blood flow respectively. Finally, rare but characteristic, sonographic appearances of villous cystic or hydropic change, may be associated with intrinsic developmental placental abnormalities such as hydatidiform mole and placental mesenchymal dysplasia, which require histological examination for their specific diagnosis.

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Section: Specific Entitiesmentioning

confidence: 99%

Correlation of placental pathology with prenatal ultrasound findings

Sebire

Sepúlveda²

2008

J Clin Pathol

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“…However, there has been a significant change in the clinical presentation of HM, with vaginal bleeding alone being the most common symptom 3 . In a recent retrospective study of 41 cases of suspected CHM, it was shown that 58% of cases presented with vaginal bleeding, whereas 41% of cases were asymptomatic 4 . A likely explanation for this is that the increasing use of ultrasound in early pregnancy allows detection of HM before the onset of systemic manifestations.…”

Section: Introductionmentioning

confidence: 99%

The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole

Kirk

Papageorghiou

Condous

et al. 2007

Ultrasound in Obstet & Gyne

110

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“…Complete moles develop from monospermic (90%) or dispermic (10%) fertilisation of an anucleate ovum by the process of self-duplication without mitosis and demonstrate no fetal tissue 8. Most women with the condition present with signs of early pregnancy bleeding or occasionally with hyperemesis (approximately 2%) 9. The classic sonographic changes of a snowstorm appearance with diffusely hydropic (‘grape-like’) chorionic villi are marked in the second trimester and may be missed on earlier ultrasonography in up to 60% of cases 10.…”

Section: Discussionmentioning

confidence: 99%

“…This is determined by a combination of factors including history, examination, βhCG levels, Doppler pelvic ultrasonography and chest x-ray. Chemotherapy is then continued until βhCG levels are normal for 6 weeks 9. Indications for chemotherapy are as follows9:…”

Section: Discussionmentioning

confidence: 99%