exudates and Hydatidiform-Mole

Gestational trophoblastic disease (GTD) is a common problem among Asian ethnics. A total of 102 women with molar pregnancies between 1 January 2005 and 31 December 2010, were analysed. The aim of the study was to determine the outcome of all molar pregnancies in our institution. The local incidence of molar pregnancy was 2.6 per 1,000 deliveries. A total of 48 women (47.1%) had complete hydatidiform mole and another 54 (52.9%) had partial mole. The mean age of the women with molar pregnancies was 32.0 ± 7.9 years. The mean gestational age at initial diagnosis was 11 weeks ± 3 days. The majority (97 women, 95.1%) had symptoms of vaginal bleeding and 18 (17.6%) women had a uterus larger than dates. A total of 48 (47.1%) women had ultrasound scan findings of 'snow-storm' appearance. None of the women with uncomplicated molar pregnancy had evidence of relapse following one undetectable serum β-hCG level. Four out of the 102 women (3.9%) developed persistent trophoblastic disease before attaining one undetectable serum β-hCG level. All four women required single agent methotrexate and they remained in remission. The prognosis for uncomplicated molar pregnancy is good. Establishment of a National Trophoblastic Centre is recommended to maintain optimal outcome.

Topics: Adolescent; Adult; Female; Humans; Hydatidiform Mole; Malaysia; Middle Aged; Pregnancy; Retrospective Studies; Tertiary Care Centers; Urban Population; Young Adult

Topics: Adolescent; Adult; Antibodies, Monoclonal; Biomarkers, Tumor; Cyclin-Dependent Kinase Inhibitor p57; Female; Humans; Hydatidiform Mole; Immunohistochemistry; Malaysia; Middle Aged; Nuclear Proteins; Pregnancy; Retrospective Studies

Gestational trophoblastic disease is a common gynaecological problem in Malaysia. The incidence of molar pregnancy is 2.8 per 1000 deliveries, being more common amongst the Chinese. The preferred method of evacuation is suction curettage; complete evacuation of the uterus was not achieved at the first attempt in 25 per cent of cases. Partial moles in our centre comprised 30 per cent of all moles. This is potentially malignant and needs follow-up for a complete mole. In the management of an invasive mole, chemotherapy should not be withheld in the presence of metastases and failure of regression of hCG. The role of prophylactic hysterectomy and prophylactic chemotherapy in the management of molar pregnancy is discussed "Selective preventive chemotherapy" in patients at "risk" appears appropriate. Chemotherapy remains the main modality of treatment for gestational trophoblastic tumours (GTT). We categorised our patients into low, medium and high-risk groups; survivals were 100, 98, and 61.7 percent respectively. These patients when categorised according to FIGO staging had survivals of 100, 80, 78.6 and 68.2 per cent respectively for stages 1, 2, 3 and 4 respectively. The reasons for the poor survival in the 'high-risk' group are discussed. Colour doppler blood flow studies are now being carried out; its role needs further evaluation. Surgery and radiotherapy have only a limited role in the management of these cases.

Topics: Choriocarcinoma; Female; Humans; Hydatidiform Mole; Malaysia; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

A clinicohistological study of acute atherosis in molar pregnancy was undertaken. Maternal decidual vessels in currettage samples of 38 histologically confirmed complete hydatidiform moles were examined histologically for acute atherosis, recognised as fibrinoid necrosis of the smooth muscle wall with a perivascular mononuclear cell infiltrate, with or without lipophages. Acute atherosis was detected in eight of 38 cases, an incidence of 18.4%. All the patients were normotensive. The significance of acute atherosis in molar pregnancy remains to be clarified.

Topics: Acute Disease; Adult; Arteries; Arteriosclerosis; Decidua; Female; Humans; Hydatidiform Mole; Incidence; Malaysia; Muscle, Smooth, Vascular; Pregnancy; Pregnancy Complications, Neoplastic; Uterine Neoplasms

Topics: Adolescent; Adult; Female; Humans; Hydatidiform Mole; Malaysia; Middle Aged; Pregnancy; Uterine Neoplasms

Topics: Adolescent; Adult; Age Factors; China; Ethnicity; Female; Geography; Humans; Hydatidiform Mole; India; Malaysia; Middle Aged; Parity; Poverty; Pregnancy; Residence Characteristics; Retrospective Studies; Seasons; Singapore

Topics: ABO Blood-Group System; Blood Group Antigens; Choriocarcinoma; Female; Humans; Hydatidiform Mole; Malaysia; Pregnancy; Racial Groups; Remission, Spontaneous; Singapore; United States

Topics: Aging; Allergy and Immunology; Asian People; Blood Group Antigens; Blood Protein Electrophoresis; Choriocarcinoma; Female; Fertility; Geography; Humans; Hydatidiform Mole; Incidence; Liver Function Tests; Malaysia; Nutritional Physiological Phenomena; Nutritional Sciences; Pregnancy; Sociology; Statistics as Topic; Trophoblastic Neoplasms; Uterine Neoplasms