IntroductionDefination: hydatidiform mole means thatafterpregnancy the placentaltrophoblasticcells proliferate abnormally,thereis stromaledema, and forms vesicula which is like grapeon itsapparence.Classification : hydatidiform mole is dividedinto complete and incomplete type
6 Introduction ❖Defination: hydatidiform mole means that after pregnancy the placental trophoblastic cells proliferate abnormally, there is stromal edema, and forms vesicula which is like grape on its apparence. ❖Classification : hydatidiform mole is divided into complete and incomplete type
No methods exist to accurately predict the clinicalbehavior of a hydatidiform mole by histopathologyThe clinical course is defined by the patient'sserum human chorionic gonadotropin (hCG) curveafter evacuationofthemole.In80%of patientswith a benign hydatidiform mole, serumhCG levels steadily drop to normal within 8-12weeks after evacuation of the molar pregnancy. Inthe other 20%of patients with a malignanthydatidiform mole, serum hCG levels either riseorplateau
7 ❖No methods exist to accurately predict the clinical behavior of a hydatidiform mole by histopathology. The clinical course is defined by the patient's serum human chorionic gonadotropin (hCG) curve after evacuation of the mole. In 80% of patients with a benign hydatidiform mole, serum hCG levels steadily drop to normal within 8-12 weeks after evacuation of the molar pregnancy. In the other 20% of patients with a malignant hydatidiform mole, serum hCG levels either rise or plateau
Etiology+the etiology is not clear:A diet deficient in animal fat and carotene may be a riskfactorEtiology of complete hydatidiform moleEpidemiology: the morbidity of hydatidiform mole is differentin different area.High risk factors:1.nourishing status,social economy2.age:over 35and 40years old;below20yearsold3.hydatidiform mole history:if a patient has the history of 1 or 2timeshydatidiform molethen the morbidity ofthe hydatidiformmole when pregnant again is 1% and 15~20% respectivelyX
8 Etiology ❖the etiology is not clear： ❖A diet deficient in animal fat and carotene may be a risk factor ❖Etiology of complete hydatidiform mole Epidemiology: the morbidity of hydatidiform mole is different in different area. High risk factors: 1.nourishing status,social economy. 2.age:over 35 and 40 years old;below 20 years old. 3.hydatidiform mole history:if a patient has the history of 1 or 2 times hydatidiform mole,then the morbidity of the hydatidiform mole when pregnant again is 1% and 15~20% respectively
GeneticfactorsA complete mole contains no fetal tissue. Ninetypercent are 46,XX, and 10% are 46,XY.1.2Complete moles can be divided into 2 types:AndrogeneticcompletemoleHomozygousTheseaccountfor80%ofcompletemolesTwoidenticalpaternalchromosomecomplements,derivedfrom duplicationofthepaternal haploidchromosomesAlwaysfemale:46,YYhasneverbeenobserved
9 Genetic factors: A complete mole contains no fetal tissue. Ninety percent are 46,XX, and 10% are 46,XY.1,2 Complete moles can be divided into 2 types: Androgenetic complete mole Homozygous These account for 80% of complete moles. Two identical paternal chromosome complements, derived from duplication of the paternal haploid chromosomes. Always female; 46,YY has never been observed
HeterozygousTheseaccountfor20%ofcompletemolesMaybemale orfemaleAll chromosomes areofparental originmost likely due to dispermy.10
10 ❖Heterozygous ❖These account for 20% of complete moles. ❖May be male or female. ❖All chromosomes are of parental origin, most likely due to dispermy