oxytocin and Hydatidiform-Mole

Topics: Abortion, Threatened; Biological Assay; Biomarkers; Depression, Postpartum; Diagnostic Techniques, Endocrine; Female; Humans; Hydatidiform Mole; Inappropriate ADH Syndrome; Labor, Obstetric; Oxytocin; Pregnancy; Radioimmunoassay; Specimen Handling; Uterine Neoplasms

Gestational trophoblastic disease cases encountered in 88 pregnant women during a period between January 1985 and June 1992 were retrospectively studied. During the same period we had 6800 deliveries. The incidence of gestational trophoblastic diseases was 12.9 per 1000 deliveries. Of these cases 72 (81.8%) were diagnosed as hydatidiform mole and 16 (18.2%) were diagnosed as choriocarcinoma in histopathological investigations. The preferred method of treatment for cases of hydatidiform mole was termination with suction curettage and oxytocin perfusion. Trophoblastic diseases were common in women with five or more pregnancies from rural areas and our incidence was higher when compared with similar studies. Moreover, our patients had low socio-economic and poor educational status. All these factors seem to be etiologic reasons, besides multiparity.

Topics: Adolescent; Adult; Choriocarcinoma; Female; Humans; Hydatidiform Mole; Middle Aged; Oxytocin; Parity; Pregnancy; Rural Population; Schools, Medical; Trophoblastic Neoplasms; Turkey; Uterine Neoplasms; Vacuum Curettage

We report the case of a pregnancy of 16 weeks with anemia and a presumptive diagnosis of partial mole. In secondary care this diagnosis was ruled out through ultrasonography and diffuse cysts were found in the myometrium. Spectral Doppler ultrasound showed no flow, but it could be observed with power angiography. Cesarean section was performed at 38 weeks and hysterectomy 24 hours after because of intra-abdominal hemorrhage. Power angiography, spectral Doppler and serum human chorionic gonadotropin are the most useful diagnostic tools in the differential diagnosis of diffuse cavernous hemangioma of the uterus. Postpartum hemorrhage is a likely complication.

Topics: Blood Transfusion; Cesarean Section; Combined Modality Therapy; Diagnosis, Differential; Female; Hemangioma, Cavernous; Hemoperitoneum; Humans; Hydatidiform Mole; Hysterectomy; Infant, Newborn; Male; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Neoplastic; Ultrasonography; Uterine Neoplasms; Young Adult

The aim of this study was to assess whether there was a change in the mode of evacuation of GTD over two time periods and to assess whether mode of evacuation influenced the subsequent need for chemotherapy.. A retrospective case note study of 4257 cases between 1986 and 1996, at a screening and treatment center managing GTD, was performed.. Between the time periods 1986-1989 and 1990-1996 there was significant change in the mode of evacuation to suction curettage. The mode of evacuation was significant in determining the need for chemotherapy. The highest rate of chemotherapy was associated with medical methods of evacuation.. Suction curettage is a safe method of uterine evacuation in GTD and its usage has increased with time. Medical methods of uterine evacuation are associated with higher rates of chemotherapy. This is probably due to a higher rate of incomplete evacuation. Medical methods of evacuation should not be used in cases of complete hydatiform mole.

Topics: Abortifacient Agents, Steroidal; Dilatation and Curettage; Female; Humans; Hydatidiform Mole; Mifepristone; Oxytocin; Pregnancy; Prostaglandins; Retrospective Studies; Uterine Neoplasms; Vacuum Curettage

A retrospective study was undertaken to assess whether stimulation of uterine contractility prior to surgical evacuation of a molar pregnancy will lead to an increased frequency of persistent trophoblastic disease. Forty-seven patients treated with chemotherapy for persistent trophoblastic disease after a hydatidiform mole between 1971 and 1988 were evaluated. The use of medical methods in this study group was compared to a control group of 219 patients with hydatidiform mole not requiring further treatment. A medical method, mainly treatment with prostaglandins, was used in 61.7% in the study group compared to 35.2% in the control group. This difference was, however, due to different stage distribution in the groups. Persistent disease was significantly correlated to uterine size and medical methods were mainly used in patients where uterine size corresponded to 15 weeks gestation or more. In this subset of patients, a medical method was used in the same frequency in both groups. Thus, large uterine size seems to be an independent risk factor. We conclude that stimulation of uterine contractility, which in Sweden is frequently used before surgical evacuation of the uterus in patients with hydatidiform mole and large uteri, carries no additional risk.

Topics: Adolescent; Adult; Combined Modality Therapy; Female; Humans; Hydatidiform Mole; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Regression, Spontaneous; Neoplasm Staging; Oxytocin; Pregnancy; Prostaglandins; Retrospective Studies; Tocolysis; Uterine Neoplasms; Uterus

Topics: Abortion, Threatened; Adult; Female; Humans; Hydatidiform Mole; Hypopituitarism; Inappropriate ADH Syndrome; Male; Oxytocin; Pituitary Function Tests; Pregnancy; Radioimmunoassay; Reference Values; Specimen Handling

Forty-eight patients of hydatidiform mole are reviewed. Forty cases (83.3%) were between 20 and 30 years of age and 24 women (50%) were primigravidae. The most common presenting symptom was intermittent bleeding. Ultrasound which became available during the latter part of the study has helped in early and definitive diagnosis. Oxytocin drip followed by suction evacuation was the mainstay of treatment. Four of the women who were followed up had persistent high titre of HCG and were treated with cytotoxic drugs. A regular follow-up is mandatory for early diagnosis and treatment of persistent trophoblastic activity.

Topics: Abortion, Therapeutic; Female; Humans; Hydatidiform Mole; Oxytocin; Pregnancy; Ultrasonography; Uterine Hemorrhage; Vacuum Curettage

From July 1, 1969 to June 30, 1985, 381 patients received primary management for hydatidiform mole at Los Angeles County-University of Southern California Medical Center Women's Hospital. Three hundred fifty-eight of these women had complete records available for analysis. Of these, 277 women (77.4%) underwent suction curettage to remove the hydatidiform mole. Sharp curettage (41 patients, 11.5%), Pitocin (15, 4.2%), hysterectomy (12, 3.4%), prostaglandins (10, 2.8%), and hysterotomy (1, 0.3%) were used less frequently. Two patients (0.6%) had no therapy after spontaneous expulsion of a mole. Complications including infection, toxemia of pregnancy, anemia or hemorrhage, and postevacuation respiratory insufficiency were recorded in 242 patients (67.6%). This experience documents that hydatidiform mole is a high-risk pregnancy that requires prompt and intensive management. Suction curettage of the uterus is clearly the best means of management in most cases.

Topics: Abortion, Therapeutic; Curettage; Female; Humans; Hydatidiform Mole; Hysterectomy; Oxytocin; Pregnancy; Prostaglandins; Suction; Uterine Neoplasms

Topics: Dilatation and Curettage; Dinoprostone; Female; Humans; Hydatidiform Mole; Hysterectomy; Labor, Induced; Oxytocin; Pregnancy; Prostaglandins E; Rh-Hr Blood-Group System; Uterine Neoplasms; Uterus

Extraamniotic PGE2 and iv oxytocin in termination of midtrimester pregnancy and in the management of missed abortion and hydatiform mole are reported. 18 patients were divided into 2 groups: 1) 12 patients received an initial dose of 200 mcg of PGE2 and subsequent instillations of 100-200 mcg/hour. If abortion was not achieved in 12 hours, oxytocin was started. 2) 6 patients received an initial dose of 500 mcg of PGE2 and subsequent instillations with 500 mcg at 4, 6, and 8 hours, respectively. If abortion was not achieved by 6 hours, oxytocin was started. Abortion was achieved in all patients; 15 within 24 hours. Comcomitant administration of extraamniotic PGE2 and iv oxytocin was shown to be a safe and efficient way of inducing midtrimester abortion, missed abortion, and hydatiform mole. This methods is associated with minimum side effects and complications.

Topics: Abortion, Induced; Abortion, Missed; Adolescent; Adult; Female; Humans; Hydatidiform Mole; Injections, Intravenous; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Prostaglandins E

Serum progesterone was measured by competitive protein binding assay at regular intervals up to 24 hours after delivery in 4 normal pregnancies. In 6 cases of hydatidiform mole, serum progesterone was assayed before and at regular intervals up to 48 hours after uterine evacuation or hysterectomy. Serum progesterone dropped rapidly by more than 50% during the first hour postpartum, and it was less than 25% of the predelivery levels 24 hours after parturition. In all 6 cases of molar pregnancies, serum progesterone fell rapidly within the first few hours after uterine evacuation. In the presence of theca lutein cysts (2 cases), serum progesterone fell much more slowly than in the absence of theca lutein cysts after removal of the mole tissue. Serum progesterone was less than 5mg/ml after total hysterectomy of uterine evacuation in moles without theca lutein cysts. These findings suggest that while the placenta is the principal source of elevated serum progesterone in normal pregnancy, the molar trophoblast is the principal source of elevated serum progesterone in hydatidiform mole, with the theca lutein cysts making a contribution when they are present.

Topics: Abortion, Induced; Abortion, Spontaneous; Binding, Competitive; Chromatography; Chromatography, Gel; Curettage; Delivery, Obstetric; Dilatation; Female; Humans; Hydatidiform Mole; Hysterectomy; Male; Ovarian Cysts; Oxytocin; Postpartum Period; Pregnancy; Progesterone; Protein Binding; Time Factors

Topics: Abortion, Missed; Chemical Phenomena; Chemistry; Female; Humans; Hydatidiform Mole; Labor, Induced; Myometrium; Oxytocin; Pregnancy; Prostaglandins F

Compared to conventional methods, therapeutic abortion up to the 12th week of gestation by the extraamnial administration of (PG) prostaglandin is undesirable because of the long-term treatment necessary and because of the danger of ascending infection. However, in cases of late therapeutic abortion, missed abortion, and hydatidiform mole, the administration of PG is the method of choice. Continuous monitoring of the intrauterine pressure during intermittent administration of PG in dosages which do not unduly prolong the time of therapy shows pathological patterns of contractions due to overstimulation of the uterus. Initial uterine tetany then shows discoordination of the contractions, high frequency of the contractions, and during the 2nd stage, excessively high intrauterine pressures. It is therefore necessary to individualize the dosage of PG according to the uterine response measured by continuous monitoring of the intrauterine pressures. (author's modified)

Topics: Abortion, Induced; Abortion, Missed; Female; Gestational Age; Humans; Hydatidiform Mole; Oxytocin; Pregnancy; Pressure; Prostaglandins; Time Factors; Uterus

In a study of 32 patients, there were 29 cases of intra-uterine fetal death and 3 cases of hydatidiform mole. The intravenous administration of either prostaglandin E1, E2 or F2 successfully induced labor in 29 out of the 32 cases. 2 patients delivered following additional intravenous oxytocin and there was 1 failure due to the development of upper limb cyanosis. Side-effects included vomitng, phlebitis, facial flushing, rigors, pyrexia and uterine hypertonus. The method confirms the high success rates reported previously but the incidence of side-effects was disturbing. It is emphasized that prostaglandin E1 was used during this original research trial when prostaglandins were 1st investigated clinically. Prostaglandin E1 has not been made available commerically.

Topics: Abortion, Induced; Adolescent; Adult; Arm; Cyanosis; Female; Fetal Death; Humans; Hydatidiform Mole; Injections, Intravenous; Labor, Induced; Oxytocin; Phlebitis; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prostaglandins; Time Factors; Uterine Diseases

Topics: Abortion, Induced; Abortion, Missed; Blood Pressure; Female; Fetal Death; Fever; Gestational Age; Humans; Hydatidiform Mole; Infusions, Parenteral; Oxytocin; Pregnancy; Prostaglandins; Pulse; Ultrasonics

Topics: Abortion, Threatened; Aminopeptidases; Birth Weight; Erythroblastosis, Fetal; Female; Gestational Age; Humans; Hydatidiform Mole; Hypertension; Infant, Newborn; Jaundice; Lung Diseases; Male; Obstetric Labor, Premature; Organ Size; Oxytocin; Polyhydramnios; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Pregnancy, Multiple; Pregnancy, Prolonged

Topics: Abortion, Criminal; Abortion, Legal; Adult; Amniocentesis; Amnion; Amniotic Fluid; Female; Humans; Hydatidiform Mole; Hypernatremia; Hypertonic Solutions; Intestinal Perforation; Maternal Mortality; Oxytocin; Postoperative Complications; Potassium; Pregnancy; Punctures; Sodium; Surgical Wound Infection; Uterine Hemorrhage; Uterine Rupture; Vasopressins; Water-Electrolyte Balance

Topics: Aminopeptidases; Choriocarcinoma; Colorimetry; Cystine; Female; Humans; Hydatidiform Mole; Oxytocin; Pregnancy; Pregnancy Complications

Topics: Choriocarcinoma; Female; Humans; Hydatidiform Mole; Hysterectomy; Mortality; Oxytocin; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Blood Pressure; Drug Therapy; Epinephrine; Ethanolamines; Female; Fetal Death; Heart Rate; Humans; Hydatidiform Mole; Norepinephrine; Oxytocin; Pharmacology; Pregnancy; Sympatholytics; Sympathomimetics; Uterus

Topics: Cervix Uteri; Choriocarcinoma; Chorionic Gonadotropin; Diagnosis; Female; Gonadotropins; Humans; Hydatidiform Mole; Hysterectomy; Methotrexate; Mortality; Oxytocin; Pregnancy; Surgical Procedures, Operative; Uterine Neoplasms

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Abortion, Therapeutic; Drug Therapy; Female; Humans; Hydatidiform Mole; Oxytocin; Pregnancy; Uterine Neoplasms

Topics: Adult; Ergonovine; Female; Gestational Age; Humans; Hydatidiform Mole; Injections, Intravenous; Methods; Middle Aged; Muscle Contraction; Ovum; Oxytocin; Pregnancy; Pregnancy Complications; Uterus

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Female; Humans; Hydatidiform Mole; Oxytocics; Oxytocin; Pregnancy; Uterine Neoplasms