![]() The ovaries often contain multiple large theca-lutein cysts as a result of increased ovarian stimulation by excessive beta-hCG ( 3). Later a complete mole is characteristically described as snowstorm appearance of mixed echogenicity, representing hydropic villi and intrauterine hemorrhage. Nowadays ultrasound scan often permits to diagnose molar pregnancy before 12 weeks, showing a fine vascular or honeycomb appearance. The diagnosis of a molar pregnancy might be suspected based on a number of clinical features: abnormal vaginal bleeding in early pregnancy is the most common presentation uterus large for dates (25%) pain from large benign theca-lutein cysts (20%) vaginal passage of grape-like vescicles (10%) exaggerated pregnancy symptoms including hyperemesis (10%), hyperthyroidism (5%), early preeclampsia (5%). The incidence of these complications is approximately 8% and 0.5% respectively, compared with a risk of 1:50,000 after a full-term pregnancy. Persistent trophoblastic disease or malignant complications are much more common with a complete molar pregnancy than with a partial hydatidiform mole. Of 3,000 women with partial hydatidiform moles, 0.1% had a choriocarcinoma. Some of these pregnancies have been reported to result in live births, with subsequent early neonatal death ( 2). In these cases, the placenta is small, the villi show minimal hydropic changes, and the fetus is growth-restricted. Very rarely, a partial molar pregnancy develops with two maternal and one paternal haploid set (digynic). The fetus usually dies within a few weeks of conception, and a recent review did not identify any case in which a fetus of paternal (diandric) origin survived to term ( 1). The hydropic villi show a less florid appearance than is seen with a complete hydatidiform mole and are interspersed with normal chorionic villi. There is usually a fetus and a large placenta. The partial hydatidiform mole is usually triploid, with one maternal and two paternal haploid sets, either from dispermic fertilization or from fertilization with an unreduced diploid sperm. There is usually no evidence of a fetus and minimal embryonal development. A complete molar pregnancy consists of diffuse hydropic chorionic villi with trophoblastic hyperplasia, forming a mass of multiple vescicles. Most have 46,XX karyotype a few have a 46,XY karyotype. The complete hydatidiform mole is usually diploid and entirely androgenetic in origin. There are 2 types of hydatidiform moles: complete and partial. The most common form of GTD is hydatidiform mole, also known as molar pregnancy.
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