Complete hydatidiform mole in a 52-year-old postmenopausal woman: A case report and literature review

Wang, Aiqin; Dong, Hui

doi:10.1016/j.crwh.2021.e00338

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…Molar pregnancy usually appears in the first trimester and can be accompanied by a variety of symptoms, including vaginal bleeding (~80%), uterine enlargement (100%), abdominal pain (42%), nausea, and vomiting (25%), as well as markedly elevated serum β-HCG levels, anaemia, hyperemesis gravidarum, theca lutein cysts, preeclampsia, and respiratory distress. β-HCG is a glycoprotein hormone structurally similar to the thyroid-stimulating hormone, and for this reason, many patients will present with clinical hyperthyroidism 10 , 14 , 15 , but in our case, the patient presented with a complaint of nausea and vomiting without any vaginal bleeding. Her surgical history includes three caesarean sections, the last being a year prior to her presentation.…”

Section: Discussionmentioning

confidence: 72%

Atypical presentation of hyperthyroidism complicated complete hydatidiform mole in a 24-year-old female: a case report

Mansour,

Almasri,

Amin

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Molar pregnancy is the most common type of gestational trophoblastic disease. It manifests as vaginal bleeding, accompanied by high levels of β-HCG. This case aims to highlight the importance of considering gestational trophoblastic disease as a potential diagnosis and its serious complications. Case Presentation: A 24-year-old female presented with vomiting, nausea, and no complaint of vaginal bleeding. Laboratory tests indicated hyperthyroidism as a complication requiring challenging preoperative prophylactic management. Initially, the patient underwent suction and curettage, but a total hysterectomy had to be performed later. The histological study concluded with the diagnosis of a complete hydatidiform mole. Post-surgery follow-up evaluations revealed high blood pressure values, and the patient was appointed for further cardiology assessment. Discussion and Conclusion: Although uncommon, complications of a molar pregnancy include anemia, severe cardiac distress, and hyperthyroidism. Trophoblastic Hyperthyroidism is a result of extremely high levels of β-HCG levels due to molecular cross-reactivity. History, clinical examination, and ultrasound, in addition to measuring β-HCG levels, could all help in diagnosing a molar pregnancy, but the definitive diagnosis is based on histopathology and a karyotype study. Management procedures include dilation, suction & curettage, and hysterectomy. The treatment depends on the patient’s age, desire for future pregnancies, and risk of developing gestational trophoblastic neoplasia. A follow-up with serial β-HCG measurement is recommended to monitor possible complications. Attaining and maintaining euthyroidism is a life-saving procedure before molar pregnancy surgery. Methimazole, Propranolol, Lugol’s iodine, and hydrocortisone can all be used in the prophylactic management of the thyroid storm.

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Section: Discussionmentioning

confidence: 72%

Atypical presentation of hyperthyroidism complicated complete hydatidiform mole in a 24-year-old female: a case report

Mansour,

Almasri,

Amin

et al. 2023

Annals of Medicine &Amp; Surgery

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“…The effectiveness of caesarean sections or intra-amniotic oxytocin and rivanol injections during the second trimester of pregnancy is up for dispute. 2,3,6 A caesarean section is recommended in order to deliver a live fetus with a hydatidiform mole because uterine contractions can push hydatidiform tissue into the abdominal cavity, increasing the risk of pulmonary embolism. During the surgery, oxytocin was used after the fast excision of the grape tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Because triploid fetuses frequently pass away in the first trimester, reports of PHM pregnancy with a live fetus are extremely uncommon. 3 There are many reports of a complete hydatidiform mole with a coexistent fetus associated with persistent gestational trophoblastic disease. Only a few cases of a partial hydatidiform mole and co-existing fetus have been reported.…”

Section: Introductionmentioning

confidence: 99%

Unsuspected partial hydatidiform moles discovered at laparotomy: A case report

Merina,

Rohmah

2023

IJPNS

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Gestational trophoblastic disease which develops from placenta and can metastases, involves hydatidiform mole also known as molar pregnancy. It’s extremely rare to have a pregnancy involving hydatidiform mole and a live fetus. A 30-year-old Javanese woman, gravida 2, para 1, referred to Temanggung Hospital who experienced uterine contractions and vaginal bleeding at 32 weeks’ gestation was considered to have placenta previa. A 2 cm cervical dilation was found during genital exam, along with a cluster of blackish red little grape-like vesicles from her vagina She has never had ultrasound examination. We decide to do emergency cesarean section with their consent. Following spinal anesthesia, the patient experienced an episode of generalized tonic-clonic seizure then she was lost consciousness and needed to be intubated. Later, for mechanical ventilation, she was sent to the ICU. a 950 g, 40 cm long male newborn was delivered with Apgar scores of 6, 6, and 7 respectively at the 1,5, and 10-minute. He was taken right away to the NICU. The placenta which was large and hydropic was recovered manually. Diagnosis was confirmed by histopathology. Ultrasound is the main method for diagnosing hydatidiform moles. There were just a few changes to the villous vesicles in PHM patients and the majority of pregnancies ended in abortion and fetal death. Despite the extremely low occurrence of the illness, this case is significant since PHM recognition and diagnosis are crucial for patient management. When delivering a live fetus with a hydatidiform mole, a caesarean section is advised because uterine contractions might drive hydatidiform tissue into the abdominal cavity, increasing the risk of pulmonary embolism. Under careful management, a partial hydatidiform mole and pregnancy can lead to the delivery of a healthy fetus and a live birth.

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“…The incidence of complete hydatidiform mole CHM and PHM is one and three per thousand pregnancies, respectively. A complete hydatidiform mole is highly rare in postmenopausal women, with just about 14 instances published in the international literature since its original description in 1973 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Management approach of a postmenopausal woman with a completely massive molar pregnancy: A case report

Omar¹,

Hussein²,

Hassan³

et al. 2022

Annals of Medicine &Amp; Surgery

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Complete hydatidiform mole in a 52-year-old postmenopausal woman: A case report and literature review

Cited by 3 publications

References 21 publications

Atypical presentation of hyperthyroidism complicated complete hydatidiform mole in a 24-year-old female: a case report

Atypical presentation of hyperthyroidism complicated complete hydatidiform mole in a 24-year-old female: a case report

Unsuspected partial hydatidiform moles discovered at laparotomy: A case report

Management approach of a postmenopausal woman with a completely massive molar pregnancy: A case report

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