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Hydatidiform Mole

Hydatidiform Mole is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Noninvasive localized tumors arising from trophoblastic tissue
  • Can be associated with malignancy
  • Twinning with normal pregnancy possible:
    • Higher risk for persistent maternal disease and metastasis
    • Possible to have normal infant
  • Complete mole:
    • Estimated in 1/1,500 pregnancies
    • Fetal tissue not present
    • Diffuse chorionic villi swelling
    • Diffuse trophoblastic hyperplasia
    • Malignancy associated in 15–20%, usually lung
    • Genetics:
      • Karyotype: 46, XX (90%); 46, XY (10%)
      • Paternal DNA expressed
      • Enucleate egg fertilized by 2 sperms or by a haploid sperm that duplicates
  • Partial mole:
    • Estimated in 1/750 pregnancies
    • Fetal or embryonic tissue often present
    • Focal chorionic villi swelling
    • Focal trophoblastic hyperplasia
    • Malignancy associated in 4–12%
    • Genetics:
      • Karyotype: 90% are triploid 69XXX, 69XXY, rarely 69XYY
      • Maternal and paternal DNA
      • Haploid ovum duplicates and is fertilized by normal sperm, or haploid ovum fertilized by 2 sperms

Etiology

  • Largely unknown
  • Extremes of maternal age best estimated risk factor:
    • >35 yr old carries 5–10-fold risk
    • <20 yr old
  • Previous molar pregnancy carries 1–2% risk in future pregnancies
  • Frequency multiple times greater in Asian and Latin American countries:
    • 1 per 1,000–1,500 live births in US and Western Europe
    • Reported up to 1 per 12–500 live births in other countries
  • Deficiency in animal fat and vitamin A
  • Smoking (>15 cigs/day)
  • Maternal blood type AB, A, or B
  • History of infertility, nulliparity
  • Finding in 1 of 600 therapeutic abortions

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Citation

Rosen, Peter, et al., editors. "Hydatidiform Mole." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307586/all/Hydatidiform_Mole.
Hydatidiform Mole. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307586/all/Hydatidiform_Mole. Accessed April 20, 2019.
Hydatidiform Mole. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307586/all/Hydatidiform_Mole
Hydatidiform Mole [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 20]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307586/all/Hydatidiform_Mole.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hydatidiform Mole ID - 307586 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307586/all/Hydatidiform_Mole PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -