A hydatidiform mole, also known as the vesicular mole, is a gestational trophoblastic malformation. The chorionic villa proliferates (rapid production of the cell) and become avascular (lack of blood supply).

The incidence of hydatidiform mole is 0.5-2.5 in the western world and 1:160 to 1:400 in India.

The risk rises where the mother has previously had a molar pregnancy history. (it is a non-cancerous tumor that develops in the uterus).

Clusters of small cysts are forms, which resemble a bunch of grapes.

Gestational Trophoblastic Disease

Gestational trophoblastic disease is refers to as gestational abnormal trophoblastic neoplasia (abnormal growth of tissue). (GTN)

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Classification

Process used to diagnose some cancer) and molecular studies are thought to be more critical.
The conventional histological classification includes hydatidiform (complete and partial).
Invasive mole (a type of neoplasia that grows into the muscular wall of the uterus. It is formed after conception. may spread to other parts of the body, e.g.-vagina, vulva and lung).
choriocarcinoma and placental site trophoblastic tumor.

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Incidence

The incidences are high at the beginning and end of the childbearing period (under 20 and over 40 years of age).
Poor nutrition
Maternal blood group A and paternal blood group O.
Genetic disposition. (inherited from a parent).

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Pathology

It is a chorion disease; the death of the embryo’s ovum or failure to grow is essential to develop a complete hydatidiform mole.

The secretion from the hyperplastic cells and substances from the maternal blood accumulate in the stroma (the supportive tissue of an epithelial organ, tumor) of the villi, devoid of blood vessels.

The expands villi from small vesicles. It is due to the edema, gas, liquid of the stroma. The distension may also be due to edema and liquefaction (the process of making something, especially a gas drink) of the stroma.

This type of mole contains no evidence of embryo, cord, or membranes.

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Types of hydatidiform molar pregnancy

Complete mole

Death of an embryo occurs before the development of the placental circulation.
The chorionic villi alter to form clear, hydronic vesicles, which hang in clusters from small pedicles.
The mass occupies the uterine cavity and can be large enough to mimic an advanced gestation.
The developing mole penetrates the uterine wall beyond the site of implantation.
Myometrium can be involved and, more rarely, the veins.
Rupture of the uterus with massive hemorrhage is a possible outcome.
Complete moles usually have 46 chromosomes of paternal origin only.
Choriocarcinoma can develop from the complete mole.

Partial mole

In this type may find evidence of an embryo, fetus, or amniotic sac as death occurs at 8thor 9thweek.
Hyperplasia (enlargement of an organ) of the trophoblast is confined to a single syncytiotrophoblast layer and is less widespread than in complete moles.
Chromosome analysis usually shows this is to be triploid with 69 chromosomes, I .e. three sets of chromosomes, one maternal and two paternal.
The risk to the mother of developing choriocarcinoma from a partial mole is slight.
Follow-up, however, is still essential.

Symptoms of hydatidiform molar pregnancy

Continuous nausea and vomiting.
Intermittent bleeding appearing dark brown seen after 20thwk of pregnancy.
Blood loss, which may lead to an unconscious state.
Breathing difficulties.
Incidence of preeclampsia or eclampsia.
Vaginal discharges with vesicles, ‘red in white current juice.’
No audible fetal heart rate.
No fetal movement.

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Diagnosis

Urinary pregnancy test, due to the massive amounts of HCG produced by the tumor, the test is positive in a dilution of 1:2000 or more after 14 wks. of gestation.
Serum levels of HCG is high.
Ultrasound scan shows a characteristic pattern and a snowstorm appearance.

Risk factors

Shock because of blood loss
DIC (disseminated intravascular coagulation)
Choriocarcinoma
Excess thyroid hormone due to the thyrotrophic hormone.
Pulmonary embolism
Hemorrhage

Treatment of hydatidiform molar pregnancy

A slow dilatation of the cervix may be achieved by using laminaria tents over 12-24hours.
Follow-up mandatory foresting the possibility of malignancy of placenta.
If persistent positive HCG levels after 6wks post evacuation, ideal to start prophylactic chemotherapy ally.
Resuscitative measures if a woman undergoes shock.
Main aim: removal of all cysts and trophoblastic tissues.
Dilatation and curettage to evacuate the uterine contents.

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Conclusion

Mollar pregnancy is not common, but it can occur in women of all ages. molar pregnancy is an emotionally flowing experience

The duration of treatment and waiting can affect your emotional, mental and physical health. Treatment is essential to ensure that no pregnancy is harmed healthily.

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Hydatidiform Molar Pregnancy: What Is It? You Need To Know