Hydatidiform mole and thyrotoxicosis. A case report.

A case is reported of coexistent hydatidiform mole and thyrotoxicosis. The latter was treated medically prior to evacuation of the mole, thereafter thyroid function returned to normal.     

Hydatidiform mole with large ovarian cysts and venous thrombosis: a case report

A 24-year-old gravida 1 with benign molar pregnancy, which was evacuated after 12 weeks of amenorrhea, developed ovarian cysts that reached the costal margin. Afterwards, she developed thrombosis, which occluded the superior vena cava as well as the right axillary vein. Treatment with streptokinase, followed by heparin and warfarin sodium, apparently resulted in a clinically complete cure. The ovarian cysts regressed spontaneously, and regular menstrual cycles recurred.     

Hydatidiform mole: a vascular congenital anomaly.

The thesis is advanced that a critical time for development of embryonic blood vessels in the placenta is 13 to 21 days after conception, especially during days 18 to 21. Dietary requirements at this time are specific and demanding for nutritional precursors of thymidine which is an important constituent of DNA. Folic acid and histidine are specifically essential for thymidine synthesis. These are reviewed with respect to cultures and socioeconomon levels in societies where occurrence of hydatidiform mole is endemic. Specific nutritional deficiencies are discussed in relation to kinds of diets and ways of food preparation. When specific dietary requirements are lacking at a time of high need, embryo death, abnormality, and/or avascularity of trophoblastic placental villi may be the earliest pathogenic signs of hydatidiform mole.     

Complete hydatidiform mole with a surviving coexistent twin in a woman with sickle cell disease: a case report

BACKGROUND: Twin pregnancy with an apparently healthy fetus and complete hydatidiform mole (CHMTF) is a rare condition. We present the first reported case in a woman with sickle cell disease. CASE: An 18-year-old woman, para 1, gravida 0, with sickle cell disease was diagnosed at 19 weeks as having a complete molar pregnancy with a coexistent live fetus. The patient presented with abdominal pain, nausea, headaches, body aches, joint pain and chest pain on 2 different occasions. She denied having vaginal bleeding. Whether the patient was having a sickle cell crisis or molar pregnancy symptoms (i.e., thyrotoxicosis) was not clear. She was given intravenous hydration and pain management. All her symptoms resolved, confirming sickle cell crisis as the final diagnosis. The pregnancy was uneventful until 35 weeks, when oligohydramnios prompted induction of labor. Suction curettage was performed after delivery for removal of the molar pregnancy. The patient did not show any evidence of persistent trophoblastic disease 2 months after delivery. CONCLUSION: CHMTF in sickle cell disease patients is challenging. Adequate intravenous hydration and pain management should be started when one suspects a crisis. If the symptoms resolved, thyrotoxicosis due to the molar pregnancy is unlikely. In addition to proper medical management, proper counseling of the patient and close monitoring of both fetus and mother should be undertaken.     

A case of a hydatidiform mole in a 56-year-old woman

A case of a 56-year-old woman with a mole pregnancy and a human chorionic gonadotropin (HCG)-induced thyreotoxicosis is presented. A proper diagnosis was only made after a period of patient and doctor's delay. After performing a hysterectomy, the HCG quickly normalized. Thyroid function normalized with thiamazol treatment. It is well known that older women have a higher risk to develop gestational trophoblastic disease (GTD). Furthermore, the chance of persistent trophoblastic disease is increased in this population. The literature on risk factors for developing persistent GTD and the possibilities for treatment in older patients is reviewed.     

Hydatidiform mole in a triplet pregnancy following gonadotropin therapy

A first case is reported of complete hydatidiform mole with two coexistent fetuses in a triple pregnancy following human menopausal gonadotropin human chorionic gonadotropin (hMG-hCG) therapy. The molar mass and two fetuses were delivered separately at 17 weeks of gestation. The fetuses were female (155 g) and male (160 g) with individual placentae (85 g, 90 g). The hydatidiform mole (650 g) had a normal 46,XX karyotype. The sexes of the two fetuses and the karyotype of the mole are consistent with previous reports that the chromosomes of fetuses and moles are derived from both parents and the father, respectively.     

Hydatidiform mole arising twice during bromocriptine therapy. Case report.

A patient with a prolactin secreting pituitary tumour is described, in whom two pregnancies occurred during bromocriptine treatment. Both were hydatidiform moles.     

Hydatidiform mole in Concepcion Palacios Maternity Hospital

An analysis of 660 hydatidiform moles observed at the Concepcion Palacios Maternity Hospital, from Caracas, Venezuela, between 1939 and 1968, is presented. In 728,431 pregnancies in women of low socioeconomic level the frequency of hydatidiform mole was 1 per 1,088; in relation to 590,158 live births this frequency is of 1 per 894. In Venezuela there are wide variations of frequency, from 1 per 423 to 1 per 1,617 pregnancies. There was a higher incidence of hydatidiform mole in primigravidas. Ninety-four per cent of the pregnancies were terminated between 4 and 28 weeks of gestation; hemorrhage was the most frequent (96.5 per cent) clinical symptoms; and 77 per cent of the pregnancies were terminated in 48 hours after admission to the hospital. In 94 per cent a vaginal method of termination was employed. To our knowledge there was only 0.9 per cent of histologic malignant degeneration in 126 women who returned to the hospital. The main conclusion is that the reasons for a wide geographic variation in incidence of hydatidiform moles are still unknown.