2024-09-14 13:00:07
Pelvic MRI showing an invasive mole in a 40-year-old patient with uterine hemorrhage. PIERRE-ADRIEN BOLZE
These are little-known female tumors, all the more cruel because they occur during the expectation of a “happy event.” In nearly one in a thousand pregnant women in the West (and nearly one in a hundred in Asia), a tumor mass develops from the placenta, this essential organ that ensures exchanges between the mother’s blood and that of the embryo.
In these pathological pregnancies, precancerous lesions, called “hydatidiform moles”, develop from a layer of cells, the trophoblast, which normally surrounds the embryo and forms numerous villi which anchor the placenta in the uterus.
These moles result from an abnormality of fertilization, always linked to an excess of chromosomal material of paternal origin, leading to either an absence of embryo or a non-viable embryo. Thus, when one or two spermatozoa fertilize an egg without a nucleus, no embryo is formed but a mole proliferates. And when two spermatozoa (or an abnormal spermatozoon) fertilize a normal egg, an embryo begins to develop, without being able to survive for long.
Spontaneous miscarriage
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Even in the absence of an embryo, the pregnancy test is positive because the placenta produces large amounts of the “pregnancy hormone,” or human chorionic gonadotropin (hCG). Most often, these moles are detected during the first or second month ultrasound. « Uterine evacuation by suction must then be carried out. [curetage] »explains Professor Pierre-Adrien Bolze, gynecological surgeon at the Lyon-Sud hospital (Hospices civils de Lyon), which houses the National Reference Center for Trophoblastic Diseases.
Sometimes these moles cause a spontaneous miscarriage, but often without expelling the entire tumor mass. The woman then presents persistent bleeding which prompts her to consult. After ultrasound and aspiration, the diagnosis is confirmed by histological analysis of the evacuated tissues.
Nearly nine times out of ten, there is no recurrence. However, it is necessary to ensure this by measuring the hCG level for six months; if it does not rise, it means that no tumor has redeveloped. In 10% to 15% of cases, however, the mole transforms into a “gestational trophoblastic tumor”, from precancerous cells persisting in the uterus. This concerns approximately 130 women per year in France, out of the 950 to 1,000 women who develop a hydatidiform mole each year.
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What are the potential risks associated with hydatidiform moles during pregnancy?
The Silent Threat of Hydatidiform Moles: Uncovering the Risks and Consequences of Abnormal Placental Growth
Introduction
For many women, pregnancy is a time of great joy and anticipation. However, for some, it can be marred by unexpected complications, including the growth of abnormal placental tissue known as hydatidiform moles. These little-known female tumors can occur during pregnancy, posing a significant threat to maternal health and even life. In this article, we will delve into the world of hydatidiform moles, exploring their causes, symptoms, diagnosis, and treatment options, as well as the importance of early detection and intervention.
What are Hydatidiform Moles?
Hydatidiform moles are abnormal growths that develop from the placenta, the essential organ that facilitates exchange between the mother’s blood and that of the embryo. In nearly one in a thousand pregnant women in the West and nearly one in a hundred in Asia, these moles can occur, often going undetected until it’s too late. Also known as molar pregnancies, they are the result of an abnormality in fertilization, leading to the development of precancerous lesions.
Causes of Hydatidiform Moles
The exact cause of hydatidiform moles is not fully understood, but research suggests that they are linked to an excess of chromosomal material of paternal origin. This can occur when:
One or two spermatozoa fertilize an egg without a nucleus, resulting in no embryo formation but mole proliferation.
Two spermatozoa (or an abnormal spermatozoon) fertilize a normal egg, leading to an embryo that is unable to survive.
Symptoms of Hydatidiform Moles
Women with hydatidiform moles may experience a range of symptoms, including:
Vaginal bleeding
Abdominal pain
Nausea and vomiting
Fatigue
Pelvic pressure
Diagnosis of Hydatidiform Moles
Diagnosis is typically made through a combination of:
Ultrasound scan: Revealing an abnormal placenta and absence of an embryo
Pregnancy test: Confirming high levels of human chorionic gonadotropin (hCG)
Histological analysis: Examining evacuated tissues to confirm the diagnosis
Treatment and Management of Hydatidiform Moles
Treatment typically involves uterine evacuation by suction, also known as curettage, to remove the abnormal tissue. In some cases, a spontaneous miscarriage may occur, but it’s essential to ensure that the entire tumor mass is removed to prevent further complications.
Consequences of Undiagnosed Hydatidiform Moles
If left untreated, hydatidiform moles can lead to serious consequences, including:
Persistent bleeding
Infection
Electrolyte imbalance
Thyrotoxic crisis
* Choriocarcinoma (a type of cancer)
Importance of Early Detection and Intervention
Early detection and intervention are critical in preventing complications and ensuring a healthy outcome for the mother. It’s essential for women to be aware of the risks and symptoms of hydatidiform moles, particularly if they have a history of abnormal pregnancies or previous molar pregnancies.
Conclusion
Hydatidiform moles are a significant but often underrecognized complication of pregnancy. By understanding the causes, symptoms, and diagnosis of these abnormal growths, we can work towards earlier detection and intervention, ultimately improving maternal health outcomes. If you or someone you know is experiencing symptoms or has been diagnosed with a hydatidiform mole, it’s essential to seek medical attention promptly to ensure the best possible outcome.
Keywords: Hydatidiform moles, molar pregnancies, placental growth, pregnancy complications, maternal health, uterine evacuation, curettage, chorionic gonadotropin, hCG, ultrasound scan, histological analysis.
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– What are the signs and symptoms of hydatidiform moles during pregnancy?
The Silent Threat of Hydatidiform Moles: Uncovering the Risks and Consequences of Abnormal Placental Growth
Introduction
For many women, pregnancy is a time of great joy and anticipation. However, for some, it can be marred by unexpected complications, one of which is the development of a hydatidiform mole. These rare tumors, which occur in approximately one in a thousand pregnancies in the West and one in a hundred in Asia, can have serious consequences for both the mother and the fetus.
What are Hydatidiform Moles?
Hydatidiform moles are abnormal growths that develop from the placenta, the essential organ that ensures exchanges between the mother’s blood and that of the embryo. They occur when a fertilized egg implants in the uterus, but the embryo fails to develop properly, leading to a mass of abnormal cells that grow and multiply rapidly.
Causes of Hydatidiform Moles
Hydatidiform moles result from an abnormality of fertilization, always linked to an excess of chromosomal material of paternal origin. This can occur in two ways: either a single sperm fertilizes an egg without a nucleus, resulting in no embryo formation, or two spermatozoa (or an abnormal spermatozoon) fertilize a normal egg, leading to an embryo that cannot survive.
Spontaneous Miscarriage
In many cases, hydatidiform moles cause a spontaneous miscarriage, but often without expelling the entire tumor mass. The woman may then experience persistent bleeding, which prompts her to consult a healthcare provider. After ultrasound and aspiration, the diagnosis is confirmed by histological analysis of the evacuated tissues.
Risks Associated with Hydatidiform Moles
Despite their rarity, hydatidiform moles can have serious consequences for women’s health. Some of the potential risks associated with these moles include:
Persistent bleeding: Hydatidiform moles can cause heavy bleeding, which can lead to anemia, fatigue, and other complications.
Infection: The tumor mass can become infected, leading to sepsis and potentially life-threatening consequences.
Gestational trophoblastic tumor: In 10-15% of cases, the mole can transform into a gestational trophoblastic tumor, a precancerous condition that requires immediate medical attention.
Recurrence: Although rare, hydatidiform moles can recur in subsequent pregnancies, making it essential for women to undergo regular monitoring and testing.
Treatment and Management
The treatment of hydatidiform moles typically involves uterine evacuation by suction, also known as curettage. In some cases, additional treatment, such as chemotherapy, may be necessary to prevent recurrence. After treatment, women must undergo regular monitoring, including hCG level measurement, to ensure that the tumor has not recurred.
Conclusion
Hydatidiform moles are a rare but potentially life-threatening complication of pregnancy. It is essential for women to be aware of the risks and symptoms associated with these moles, as early detection and treatment can significantly improve outcomes. By understanding the causes, risks, and consequences of hydatidiform moles, women can take steps to protect their health and well-being during pregnancy.
Keywords: hydatidiform moles, placental tumors, pregnancy complications, spontaneous miscarriage, gestational trophoblastic tumor, women’s health.
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