Molar pregnancy

Molar Pregnancy Mohammed khairy Assisted lecture of obstetric and gynecology Assiut university- Egypt [email_address]

Introduction ,[object Object],[object Object],[object Object]

Case Report (Partial mole) ,[object Object],[object Object],[object Object]

First visit ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

First visit ,[object Object],[object Object],[object Object],[object Object],[object Object]

Provisional diagnosis ,[object Object]

Second visit (2 week later) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Second visit (2 week later) ,[object Object],[object Object],[object Object]

Laboratory Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object]

Post-evacuation abdominal U/S ,[object Object],[object Object]

Post-evacuation plan ,[object Object],[object Object],[object Object]

Post-evacuation HCG (7 days later) ,[object Object]

[object Object],[object Object],[object Object],[object Object]

Incidence of molar pregnancy (RCOG 2010) ,[object Object],[object Object],[object Object]

Predisposing factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Complete Mole ,[object Object],[object Object]

Empty ovum Empty ovum 46XX 46XX or 46XY 23X or Y 23X 23X Complete Mole (46XX diploid) Complete Mole (46XX or 46XY, diploid) Complete Mole

COMPLETE HYDATIFORM MOLE CLINICAL FEATURES Vaginal bleeding (anemia) 97% Excessive uterine size 50% Theco-lutein ovarian cysts 50% Preeclampsia 27% Hyperemesis 25% Hyperthyroidism 7% Trophoblastic embolization 2%

Partial Molar Pregnancy ,[object Object],[object Object]

23X 23X Dyspermy 23X/23Y or 23X/23X 23Y Partial Mole (69XXY, or 69XXX, or 69XYY triploid) 23X 23X 23Y 69XXY Partial Molar Pregnancy

Complete mole Partial mole Karyotype 46XX ,46XY Triploid (69 XXY) Fetal or embryonic tissue absent present Hydatiform swelling of chorionic villi extensive focal Trophoblastic hyperplasia extensive focal Theca-lutein cysts 25–30% less common Medical complications Frequent less common Gestational trophoblastic neoplasia 20% <5–10% HCG level very high Slight raised Differance between COMPLETE AND PARTIAL MOLE

Ultrasonographic D/D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hydatidiform Mole with co-existent foetus (RCOG 2010) ,[object Object],[object Object]

Human chorionic Gonadotropin ,[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnostic Implications of Serum HCG levels ,[object Object],[object Object],[object Object],[object Object]

Correlation between HCG level, and sonography findings ,[object Object],[object Object],[object Object]

Serum HCG levels after non trophoblastic Abortions ,[object Object],[object Object],[object Object]

HCG Levels –after trophoblastic abortions ,[object Object],[object Object]

HCG levels -Management ,[object Object],[object Object],[object Object],[object Object],[object Object]

Molar pregnancy

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