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Low intake of proteins and vitamin A, Asian heritage, Women older than 35 years
Partial mole
or
Complete mole
Uterus
expands Abdominal
Trophoblastic proliferation faster than pain
normal
Ovarian
pain
Pallor Preeclampsia
Note: Those inside the boxes end up as the signs & symptoms of H mole.
II. WHAT IS GESTATIONAL TROPHOBLASTIC DISEASE?
Gestational Trophoblastic Disease, existing in many terms like Hydatidiform Mole, is a condition associated
with second-trimester bleeding. It is an abnormal proliferation and degeneration of the trophoblastic villi. As the cells
degenerate, they become filled with fluid and appear as clear fluid-filled, grape-sized vesicles. With this condition, the
embryo fails to develop beyond a primitive start. Such structures must be identified because they are associated with
choriocarcinoma, a rapidly metastasizing malignancy. The incidence of gestational trophoblastic disease is
approximately 1 in every 1,500 pregnancies.
Sperm Ovum
2 4
3 + + Duplication = 6
Partial Mole: With a partial mole, some of the villi form normally. The syncytiotrophoblastic layer of the villi, however,
is swollen and misshapen. A macerated embryo of approximately 9 weeks; gestation may be present in the villi. A
partial mole has 69 chromosomes (a triploid formation in which there is three chromosomes instead of two for every
pair, one set supplied by an ovum that apparently was fertilized by two sperm or an ovum fertilized by one sperm in
which meiosis or reduction division did not occur). This could also occur if one set of 23 chromosomes was supplied
by one sperm and an ovum did not undergo reduction division supplied 46 (see Fig. 2). In contrast to complete moles,
partial moles rarely lead to choriocarcinoma.
Sperm Ovum
4 2 6
6 + 3 = 9
or
Fig. 2. Partial 2
mole.
3
2 6
+ + 3 = 9
2
3
FEATURES COMPLETE PARTIAL
• Embryonic/fetal tissue Absent (whole conceptus is Present (with fetus or at least an
transformed into a mass of vesicles) amniotic sac)
Diffuse
• Swelling of villi Diffuse Focal
B. Signs:
1. preeclampsia develops in 20 – 30 % cases, usually before 20 weeks’ AOG
2. pallor indicating anemia may be present
3. hyperthyroidism develops in 3-10% of cases manifested by enlarged thyroid gland and tachycardia (due
to chorionic thyrotropin secreted by the trophoblast and hCG also has a thyroid-stimulating effect)