Molar pregnancy
Citation, DOI, disclosures and article data
At the time the article was created The Radswiki had no recorded disclosures.
View The Radswiki's current disclosuresAt the time the article was last revised Yoshi Yu had no financial relationships to ineligible companies to disclose.
View Yoshi Yu's current disclosures- Hydatidiform moles
- Hydatidiform molar pregnancies
- Molar pregnancies
- Hydatidiform mole
- Hydatidiform molar pregnancy
Molar pregnancies, also called hydatidiform moles, are one of the most common forms of gestational trophoblastic disease.
On this page:
Epidemiology
Molar pregnancies are one of the common complications of gestation, estimated to occur in one of every 1000-2000 pregnancies 3. These moles can occur in a pregnant woman of any age, but the rate of occurrence is higher in pregnant women in their teens or between the ages of 40-50 years. There is a relatively increased prevalence in Asia (for example compared with Europe).
Pathology
Subtypes
A hydatidiform mole can either be complete or partial. The absence or presence of a fetus or embryo is used to distinguish the complete from partial moles:
complete moles are associated with the absence of a fetus
partial moles usually occur with an abnormal fetus or may even be associated with fetal demise
Rarely, moles co-exist with a normal pregnancy (co-existent molar pregnancy), in which a normal fetus and placenta are seen separate from the molar gestation.
Chromosomal composition
Ninety percent of complete hydatidiform moles have a 46XX diploid chromosomal pattern. All the chromosomes are derived from a single sperm in 90% or less likely two sperms, suggesting fertilization of a single egg that has lost its chromosomes.
With partial moles, the karyotype is usually triploid (69XXY), the result of fertilization of a normal egg by two sperm, one bearing a 23X chromosomal pattern and the other a 23Y chromosomal pattern.
Location
Complete hydatidiform moles usually occupy the uterine cavity and are rarely located in fallopian tubes or ovaries.
The chorionic villi are converted into a mass of clear vesicles that resemble a cluster of grapes.
Markers
In the classic case of molar pregnancy, quantitative analysis of beta-HCG shows hormone levels in both blood and urine greatly exceeding those produced in normal pregnancy at the same stage.
Radiographic features
Please refer to the dedicated articles for discussion on the radiographic features:
Treatment and prognosis
A complete mole can progress to invasive mole (~15%) or to gestational choriocarcinoma (~7%).
History and etymology
The term is derived from the Greek word hydatisia meaning "drop of water" and mola meaning "false conception" 7.
References
- 1. Fine C, Bundy A, Berkowitz R, Boswell S, Berezin A, Doubilet P. Sonographic Diagnosis of Partial Hydatidiform Mole. Obstet Gynecol. 1989;73(3 Pt 1):414-8. - Pubmed
- 2. Narlawar R, Shah J, Patkar D. Images in Radiology: Complete Hydatidiform Mole with Live Pregnancy in a Twin Gestation. J Postgrad Med. 2000;46(4):291-2. - Pubmed
- 3. Green C, Angtuaco T, Shah H, Parmley T. Gestational Trophoblastic Disease: A Spectrum of Radiologic Diagnosis. Radiographics. 1996;16(6):1371-84. doi:10.1148/radiographics.16.6.8946542 - Pubmed
- 4. Wagner B, Woodward P, Dickey G. From the Archives of the AFIP. Gestational Trophoblastic Disease: Radiologic-Pathologic Correlation. Radiographics. 1996;16(1):131-48. doi:10.1148/radiographics.16.1.131 - Pubmed
- 5. Powell M, Buckley J, Worthington B, Symonds E. Magnetic Resonance Imaging and Hydatidiform Mole. Br J Radiol. 1986;59(702):561-4. doi:10.1259/0007-1285-59-702-561 - Pubmed
- 6. Marisa R. Nucci, Esther Oliva. Gynecologic Pathology. (2009) ISBN: 9780443069208 - Google Books
- 7. Carey L, Nash B, Wright D. Molecular Genetic Studies of Complete Hydatidiform Moles. Transl Pediatr. 2015;4(2):181-8. doi:10.3978/j.issn.2224-4336.2015.04.02 - Pubmed
Incoming Links
- Pre-eclampsia
- Abnormally thickened endometrium (differential)
- Perigestational haemorrhage
- Placental chorioangioma
- Breus mole
- Uterine enlargement (differential)
- Retroplacental complex
- Large for dates uterus
- Bunch of grapes sign (disambiguation)
- Placentomegaly
- Food inspired signs
- Placental site trophoblastic tumour
- Partial hydatidiform mole
- Gestational trophoblastic disease
- Complete hydatidiform mole
- Placental mesenchymal dysplasia
- Intrauterine blood clot
- Differential diagnosis of free fluid in cul de sac (pouch of Douglas)
- Incomplete miscarriage with bilateral theca lutein cysts
- Uterine arteriovenous malformation
- Molar pregnancy
- Theca lutein cysts
- Complete hydatidiform mole
- Complete hydatidiform mole
- Complete hydatidiform molar pregnancy
- Molar pregnancy with coexisting live intrauterine pregnancy
- Molar pregnancy
- Hydatidiform mole
- Complete hydatidiform molar pregnancy
- Molar pregnancy
- Partial molar pregnancy
- Partial hydatidiform mole
- Partial hydatidiform mole
- Hydatidiform mole
- Placental mesenchymal dysplasia
- Partial hydatidiform mole
- Complete hydatidiform mole
- Complete hydatidiform mole
Related articles: Pathology: Genitourinary
- obstetrics
-
first trimester
- ultrasound findings in early pregnancy
- embryo/fetus
- beta-hCG levels
- confirming intrauterine gestation
- pregnancy of unknown location (PUL)
- first trimester vaginal bleeding
- early structural scan
- aneuploidy testing
-
second trimester
- fetal biometry
- amniotic fluid volume
- fetal morphology assessment
- soft markers
- amnioreduction
- Doppler ultrasound
- nuchal translucency
- 11-13 weeks antenatal scan
- chorionic villus sampling (CVS) and amniocentesis
- other
- placenta
- placental anatomy
- placental developmental abnormalities
- placenta previa
- spectrum of abnormal placental villous adherence
- abnormalities of cord insertion
- abruptio placentae
- placental pathology
- vascular pathologies of placenta
- placental infections
- placental masses
- molar pregnancy
- twin placenta
- miscellaneous
-
first trimester
- gynecology
- acute pelvic pain
- chronic pelvic pain
- uterus
- ovaries
- ovarian follicle
- ovarian torsion
- pelvic inflammatory disease
- ovarian cysts and masses
- paraovarian cyst
- polycystic ovaries
- ovarian hyperstimulation syndrome
- post-hysterectomy ovary
- cervix
- fallopian tube
- other
- male genital tract
- prostate gland
- transrectal ultrasound
- prostate tumors
- infections of the prostate
-
prostatitis
- acute bacterial prostatitis
-
chronic prostatitis
- chronic bacterial prostatitis
- chronic prostatitis and chronic pelvic pain syndrome (CPPS)
- asymptomatic inflammatory prostatitis
- granulomatous prostatitis
- emphysematous prostatitis
- prostatic abscess
-
prostatitis
- benign prostatic hypertrophy
- cystic lesions of the prostate
- prostatic calcification
- prostatic infarction
- testes
-
unilateral testicular lesion
- testicular torsion
- orchitis
- testicular trauma
-
germ cell tumors of the testis
- testicular seminoma
-
non seminomatous germ cell tumors
- mixed germ cell tumor
- yolk sac tumor (endodermal sinus tumor)
- embryonal cell carcinoma
- choriocarcinoma
- testicular teratoma
- testicular epidermoid (teratoma with ectodermal elements only)
- burned out testis tumor
- sex cord / stromal tumors of the testis
- testicular cyst
- testicular lymphoma
- bilateral testicular lesion
- paratesticular lesions
- epididymis
- other
- polyorchidism
- cryptorchidism
- tubular ectasia of the rete testis
- cystadenoma of the rete testis
- testicular sarcoidosis
- testicular tuberculosis
- spermatic cord
- fibrous pseudotumor of the scrotum
- scrotal leiomyosarcoma
- testicular adrenal rest tumors (TARTs)
- tunica vaginalis testis mesothelioma
- splenogonadal fusion
- testicular vasculitis
- abnormal testicular Doppler flow (differential)
-
unilateral testicular lesion
- penis
- prostate gland
- KUB
- kidneys
- normal renal anatomy
- hydronephrosis
- urolithiasis
- renal masses
- renal cystic disease
- renal infection
- vascular
- trauma
- ureter
- normal ureter anatomy
- ureteral stricture
- ureteral dilatation
- ureteral anomalies
- ureteral tumors
- ureteral trauma
- other
- bladder
- kidneys