Hydatiform mole
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Diagnosis |
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Hydatiform mole On the Web |
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Etiology
The etiology of this condition is not completely understood. Potential risk factors may include defects in the egg, abnormalities within the uterus, or nutritional deficiencies. Women under 20 or over 40 years of age have a higher risk. Other risk factors include diets low in protein, folic acid, and carotene.
Treatment
Hydatidiform moles should be treated by evacuating the uterus by uterine suction or by surgical curettage as soon as possible after diagnosis. Patients are followed up until their serum human chorionic gonadotrophin (hCG) titre has fallen to an undetectable level. Invasive or metastatic moles often respond well to methotrexate. The response to treatment is nearly 100%. Patients are advised not to conceive for one year after a molar pregnancy. The chances of having another molar pregnancy are approximately 1%.
Prognosis
More than 80% of hydatidiform moles are benign. The outcome after treatment is usually excellent. Close follow-up is essential. Highly effective means of contraception are recommended to avoid pregnancy for at least 6 to 12 months.
In 10 to 15% of cases, hydatidiform moles may develop into invasive moles. These may intrude so far into the uterine wall that hemorrhage or other complications develop. It is for this reason that a post-operative full abdominal and chest x-ray will often be requested.
In 2 to 3% of cases, hydatidiform moles may develop into choriocarcinoma, which is a malignant, rapidly-growing, and metastatic (spreading) form of cancer. Despite these factors which normally indicate a poor prognosis, the rate of cure after treatment with chemotherapy is high.
Over 90% of women with malignant, non-spreading cancer are able to survive and retain their ability to have children. In those with metastatic (spreading) cancer, remission remains at 75 to 85%, although the ability to have children is usually lost.
References
- Original source: http://www.nlm.nih.gov/medlineplus/ency/article/000909.htm
External links
- Complete moles have paternal chromosomes but maternal mitochondrial DNA by Douglas C. Wallace, Urvashi Surti, Camellia W. Adams and A. E. Szulman, Volume 61, Number 2 of Human Genetics
- MyMolarPregnancy.com Support group, information, links and personal stories for women with molar pregnancies.
- Molar Pregnancy Early pregnancy loss
Acknowledgements
The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.
List of contributors: