Hydatidiform mole
Hydatidiform mole Causes
A diet deficient in animal fat and carotene may act as a risk factor.
Hydatidiform mole Definition
A hydatidiform mole (or hydatid mole, mola hytadidosa) is an anomalous growth containing a nonviable embryo which implants and proliferates within the uterus.
Hydatidiform mole Diagnosis
The diagnosis is strongly suggested by ultrasound (sonogram), but definitive diagnosis needs histopathological examination. The mole is grossly similar to a bunch of grapes ("cluster of grapes" or "honeycombed uterus" or "snow-storm"). There is a heightened trophoblast proliferation and enlargening of chorionic villi. The angiogenesis in the trophoblasts are not functioning as well.
Hydatidiform mole Symptoms and Signs
Molar pregnancies typically present with painless vaginal bleeding in the fourth to fifth month of pregnancy. The uterus may be bigger than expected, or the ovaries may be enlarged. There may also be increased vomiting than would be expected (hyperemesis). Sometimes there is a raise in blood pressure along with protein in the urine. Blood tests will show extremely high levels of human chorionic gonadotropin (hCG).
Hydatidiform mole Treatment
Hydatidiform moles should be treated by evacuating the uterus by uterine suction or by surgical curettage as early as possible after diagnosis, in order to avoid the risks of choriocarcinoma. Patients are followed up until their serum human chorionic gonadotrophin (hCG) level has decreased to an undetectable level. Invasive or metastatic moles (cancer) may need chemotherapy and often respond well to methotrexate. The response to treatment is almost 100%. Patients are told not to conceive for one year after a molar pregnancy. The probability of having another molar pregnancy are approximately 1%. Management is more complex when the mole occurs together with one or more normal fetuses. Carboprost medication may be used to make the uterus contract.