1.Incidence and epidemiology Incidence varies dramatically in different regions of the world In USA or Europe,1 in 1500 pregnancies In Mexico,1 in 125 In Far East and Southeast Asian,5 to 15 fold than in USA Complete is more often than incomplete
1. Incidence and epidemiology Incidence varies dramatically in different regions of the world ²In USA or Europe, 1 in 1500 pregnancies ²In Mexico, 1 in 125 ²In Far East and Southeast Asian, 5 to 15 fold than in USA Complete is more often than incomplete
High risk factors women≤20and>40 years Low economic status Nutrition:diets deficient in protein and folic acid,carotene deficiency Particular ABO blood groups Cell heredity:abnormal fertilization of ovum and sperm,enucleate egg,triploid, especially the abnormal of sperm
High risk factors ²women < 20 and >40 years ²Low economic status ²Nutrition: diets deficient in protein and folic acid, carotene deficiency ²Particular ABO blood groups ²Cell heredity: abnormal fertilization of ovum and sperm, enucleate egg, triploid, especially the abnormal of sperm
2.Pathology Gross Various vesicles,thin wall,transparent, mucous fluid,blood and clots filled in vesicle space Histologic character Trophoblast proliferate Edema of villous stroma No embryogenetic blood vessels in stroma
2. Pathology Gross ²Various vesicles, thin wall, transparent, mucous fluid, blood and clots filled in vesicle space Histologic character ²Trophoblast proliferate ²Edema of villous stroma ²No embryogenetic blood vessels in stroma
Comparison between complete and incomplete type Feature Complete Incomplete Villous edema Diffuse Focal Trophoblastic cell Diffuse Focal hyperplasia Embryonic tissue Absent Present Slight B-hCG High (>50 000) elevation Diploid Triploid Karyotype 46XX(90%) 69XXY(90%) Genetic parentage Paternal Biparental
Comparison between complete and incomplete type Feature Complete Incomplete Villous edema Diffuse Focal Trophoblastic cell hyperplasia Diffuse Focal Embryonic tissue Absent Present β-hCG High (>50 000) Slight elevation Karyotype Diploid 46XX(90%) Triploid 69XXY(90%) Genetic parentage Paternal Biparental
Theca-lutein cysts Surface is smooth,yellowish and lined with luteal cells,diameter from 10cm to more, thin wall,multichamber in section Overstimulation of luteal elements by large amounts of chorionic gonadotropin secreted by proliferated trophoblast Often occurred in both side and in complete (30%-50%)
Theca-lutein cysts ²Surface is smooth, yellowish and lined with luteal cells, diameter from 10cm to more, thin wall, multichamber in section ²Overstimulation of luteal elements by large amounts of chorionic gonadotropin secreted by proliferated trophoblast ²Often occurred in both side and in complete (30%~50%)