Gestational Trophoblastic Disease Flashcards
1
Q
What are the GTDs?(6)
A
- complete hydatidiform mole
- partial mole
- invasive mole
- choriocarcinoma
- placental site trophobkastic tumor
- epitheliod trophoblastic tumor
2
Q
Incidence of GTD
A
1:714
3
Q
Most common karyotype of CHM
A
Diploid 46XX
-75-80%
-Paternal origin
- empty ovum with duplicated sperm
4
Q
Other karyotype of CHM
A
46 XX or 46 XY
- dispermic fertilization
- 20- 25%
5
Q
What is the genetic predisposition to CHM
A
NLRP7 - Chromosome 19q
- autosomal recessive
- associated with recurrent mole
- maternal and paternal DNA (dipload)
6
Q
Karyotype of partial mole
A
- triploid 69 xxy/xyy/xxx (90%)
- tetrapoid/mosaic (10%)
- dispermic fertilization of ovum with genetic material
7
Q
What is the risk of recurrence of HM?
A
- 2% following 1 mole
- 20% following 2 moles
8
Q
Histopathology of CHM (3)
A
- diffuse villus hydrops
- diffuse trophoblast hyperplasia
- cluster of grapes macroscopically
9
Q
Histology partial mole (4)
A
- focal villas hydrops
- focal trophoblast hyperplasia
- trophoblacyix pseudoinclusions
- identifiable fetal tissue
10
Q
Which mole is p57 detected in on immunohistochemistry?
A
Partial mole
11
Q
Risk of requiring chemotherapy in CHM
A
13-16%
12
Q
Risk of requiring chemotherapy in PM
A
.5- 1%
13
Q
Common presentation of CHM (2)
A
- irregular vaginal bleeding in early pregnancy
- ultrasound findings polypoid mass with multiple echoes (snowstorm pattern)
14
Q
Less frequent features (4)
A
- hypermesis gravidarum
- early onset pre eclampsia
- LGA
- abdominal dissension to the theca lutein cyst
15
Q
Ultrasound features PM(3)
A
- enlarged placental tissue
- cystic changes within the decidual reaction with an empty gestational sac
- increased transverse diameter of GS (ratio >1.5)
