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Federación Mexicana de Ginecología y Obstetricia, A.C.

2012, Number 08

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Ginecol Obstet Mex 2012; 80 (08)

Diagnosis of Molar Pregnancy by Hysteroscopy

Ayala YR, Briones LC, Anaya CH, Leroy LL

Language: Spanish
References: 19
Page: 540-544
PDF size: 125.58 Kb.


ABSTRACT

Background: Gestational trophoblastic disease has a high incidence worldwide. Proper pre-evacuation diagnosis must be performed due to the risk of malignant complications associated with hydatidiform moles. Diagnosis of early molar pregnancies might be elusive due to atypical clinical manifestations and inconclusive ultrasonographic findings.
Objective: Report on the efficiency and precision by hysteroscopy for the diagnosis of molar pregnancy in one particular case.
Clinical case: Thirty-year old woman, 5.6-week pregnant, suffering from pelvic pain, uterine bleeding and high concentrations of human chorionic gonadotropin beta fraction ( β -hCG). Ultrasonography suggested inconclusively either a hematoma or a gestational sac so that further evaluation by hysteroscopy had to be performed in order to reach a proper diagnosis.
Results: Hysteroscopic evaluation provided conclusive diagnostic images of hydropic degeneration of the chorionic villi. Histopathological evaluation confirmed a molar pregnancy. The mole was removed by uterine curettage and β-hCG tests followed.
Conclusions: Hysteroscopy is a useful tool for diagnostic protocol in case of early atypical molar pregnancy.


REFERENCES

  1. De Anrade JM. Hydatidiform mole and gestational trophoblastic disease. Rev Bras Ginecol Obstet 2009;31:94-101. PMID:19407915.

  2. ACOG Practice Bulletin No. 53. Diagnosis and treatment of gestational trophoblastic disease. Obstet Gynecol 2004;103:1365-1377.

  3. Altieri A, Franceschi S, Ferlay J, Smith J, La Vecchia C. Epidemiology and aetiology of gestational trophoblastic diseases. Lancet Oncol 2003;4:670-678.

  4. Suárez Rincón AE, Santana Torres RM, Pantoja Torres CO, Pérez Ávila CE, Vázquez Martínez H. Incidencia de enfermedad trofoblástica gestacional detectada por el estudio histopatológico rutinario de los especímenes obtenidos de abortos. Ginecol Obstet Mex 2008;76:81-87.

  5. Garner El, Goldstein DP, Feltmate CM, Berkowitz RS. Gestactional trophoblastic disease. Clin Obstet Gynecol 2007;1:112-122.

  6. Acaia B, Parazzini F, La Vecchia C, Ricciardiello O, Fedele L, Battista Candiani G. Increased frequency of complete hydatidiform mole in women with repeated abortion. Gynecol Oncol 1988;31:310-314.

  7. Sebire NJ, Seckl MJ. Gestation trophoblastic disease: current management of hydatidiform mole. BMJ 2008;337:a1193. doi:10.1136/bmj.a1193.

  8. Gemer O, Segal S, Kopmar A, Sassoon E. The current clinical presentation of complete molar pregnancy. Arch Gynecol Obstet 2000;264:33-34.

  9. Sebire NJ, Rees H, Paradinas F, Seckl M, Newlands E. The diagnostic implications of routine ultrasound examination in histologically confirmed early molar pregnancies. Ultrasound Obstet Gynecol 2001;18:662-665.

  10. Berkowitz RS, Goldstein DP. Current management of gestational trophoblastic diseases. Gynecologic Oncology 2009;112:654-662.

  11. Fowler DJ, Lindsay I, Seckl MJ, Seibre NJ. Routine preevacuation ultrasound diagnosis of hydatidiform mole: experience of more than 1000 cases from a regional referral center. Ultrasound Obstet Gynecol 2006;27:56-60.

  12. Alhamdan D, Bignaridi T, Condous G. Recognizing gestational trophoblastic disease. Best Pract Res Clin Obstet Gynaecol 2009;23:565-573.

  13. Oróstegui S, Arenas YA, Galindo LM. Enfermedad trofoblástica gestacional. MedUNAB 2008;11:140-148.

  14. Kirk E, Papageorghiou AT, Condous G, Bottomley C, Bourne T. The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole. Ultrasound Obstet Gynecol 2007;29(1):70-75.

  15. Paradinas FJ. The histological diagnosis of hydatidiform moles. Curr Dianostic Pathol 1994;1:24-31.

  16. Goycoolea JP, Rojas I. Histeroscopia diagnóstica: rendimiento en el estudio de la metrorragia e inocuidad ante un eventual cáncer de endometrio, revisión de la literatura. Rev Chil Obstet Ginecol 2007;72(3):190-196.

  17. Bain C, Parkin DE, Cooper KG. Is outpatient diagnostic hysteroscopy more useful than endometrial biopsy alone for the investigation of abnormal uterine bleeding in unselected premenopausal women? A randomized comparison. BJOG 2002;109:805-811.

  18. Suzyki A, Kawaguchi K, Konishi I, Ida K, Fuji S, Matsuura S. Role of hysteroscopy in diagnosis and management of trophoblastic disease. Nippon Sanka Fujinka Gakkai Zasshi 1984;36:255-260.

  19. Di Spiezio Sardo A, Bettocchi S, Coppola C, Greco E, Camporiale AL, Granata M, Nappi C. Hysteroscopic identification of hydatidiform mole. J Minim Invasive Gynecol 2009;16:408-409.




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