Objective: The aim of the study was to identify the incidence, diagnosis, therapeutic and histological particularities of molar pregnancies and to evaluate our management of gestational trophoblastic tumors (GTT) according to the recommendations of FIGO.
Methods: This was a retrospective study of 90 patients who were diagnosed with molar pregnancy from January 1991 to December 2007. After remission, post molar pregnancy surveillance was continued for one year. Patients whose condition required chemotherapy for GTT were attributed a FIGO/WHO score.
Results: Molar pregnancy occurred in 90 women. The frequency of molar pregnancy was 1 per 1124 pregnancies. The mean age was 32.21 years. Molar pregnancies were more frequent in pauciparous patients (52.24%). At diagnosis, the median gestational age was 13 weeks. The main presenting symptom was metrorrhagia (90%). Treatment consisted in uterine evacuation by suction curettage. Histological findings were complete mole in 66.66% of the cases and partial mole in 33.33% of the cases. 81 patients (90%) achieved remission without chemotherapy and 9 patients (10%) had FIGO stage I GTT. They achieved remission with a monochemotherapy.
Conclusion: The practice of ultrasonography in the first trimester of pregnancy allows an early diagnosis of molar pregnancy and an adequate treatment and follow-up.
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Am J Case Rep
January 2025
Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
BACKGROUND Gestational trophoblastic diseases (GTDs) are a group of benign and malignant tumors that arise from placental tissue. Ectopic pregnancies most commonly occur within the fallopian tubes. The estimated incidence of ectopic gestational trophoblastic diseases (GTDs) is approximated at 1.
View Article and Find Full Text PDFExpert Rev Mol Diagn
January 2025
Department of Pathology, Yale University School of Medicine, New Haven.
Introduction: Gestational trophoblastic disease (GTD) encompasses a constellation of rare to common gynecologic conditions stemming from aberrant gestations with distinct genetic backgrounds and variable degrees of trophoblast proliferation of either neoplastic or non-neoplastic nature. GTD is categorized into hydatidiform moles and gestational trophoblastic neoplasms, and their clinical outcomes vary widely across different subtypes. Prompt and accurate diagnosis plays a pivotal role in the effective management and prognostication of patients.
View Article and Find Full Text PDFGynecol Oncol
January 2025
Department of Pathology of UFCSPA and Department of Pathology of Irmandade de Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Brazil.
Objective: To evaluate the efficacy of actinomycin D (ActD) as prophylactic chemotherapy (P-chem) in patients with high-risk complete hydatidiform mole (Hr-CHM) on progression to gestational trophoblastic neoplasia (GTN).
Methods: From 1996 to 2023, 426 Hr-CHMs were selected in a cohort of 1623 patients with gestational trophoblastic disease (GTD). From 1996 to 2023, 290 patients with Hr-CHMs received a single bolus dose of Act-D at the time of uterine evacuation (Hr-CHM P-chem group); 136 with the same risk factors did not receive P-chem (Hr-CHM control group).
Obstet Gynecol Surv
December 2024
Associate Professor.
Importance: Rhesus alloimmunization refers to the sensitization of an Rh D-negative mother after exposure to D-positive fetal red blood cells, which can lead to significant fetal and neonatal morbidity and mortality.
Objective: The aim of this study was to review and compare the most recently published international guidelines on the prevention of maternal alloimmunization.
Evidence Acquisition: A comparative review of guidelines from the American College of Obstetricians and Gynecologists, the British Committee for Standards in Hematology, the International Federation of Gynecology and Obstetrics, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada regarding the prevention of maternal Rh D alloimmunization was conducted.
J Obstet Gynaecol Res
January 2025
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Aim: While manual vacuum aspiration (MVA) is commonly employed for early first-trimester abortions, its effectiveness in treating hydatidiform mole is still unclear. This study sought to evaluate the efficacy and safety of MVA in comparison to dilation and curettage (D&C) for managing hydatidiform mole.
Methods: We conducted a retrospective review of medical records for 198 patients with hydatidiform mole treated at Nagoya University Hospital between 2004 and 2023.
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