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Int J Surg Case Rep 2022 Jun 18;96:107320. Epub 2022 Jun 18.

Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.

Introduction And Importance: Here, we discuss novel management with methotrexate for the rare case of a complete hydatidiform mole with a co-existing fetus (CHMCF). The management of CHMCF is controversial, and methotrexate might represent a solution. CHMCF management with methotrexate needs more study, especially its side effects, safe dosage, and the permissible period of pregnancy. Read More

Surg Pathol Clin 2022 Jun 20;15(2):197-218. Epub 2022 May 20.

Department of Pathology, Yale School of Medicine, 310 Cedar Street LH 108, PO Box 208023, New Haven, CT 06520-8023, USA. Electronic address:

Pathologic diagnosis of gestational trophoblastic disease (GTD)-hydatidiform moles and gestational trophoblastic neoplasms-underwent a major shift in the past decade from morphology-based recognition to precise molecular genetic classification of entities, which also allows for prognostic stratification of molar gestations. This article highlights these recent advances and their integration into the routine pathology practice. The traditional gross and histomorphologic features of each entity are also reviewed with special focus on differential diagnoses and their clinical implications. Read More

Int Med Case Rep J 2022 9;15:275-280. Epub 2022 Jun 9.

Department of Obstetrics and Gynecology, Madda Walabu University, Goba Referral Hospital, Goba, Oromia, Ethiopia.

Background: Twin pregnancy with partial hydatidiform mole and a co-existing normal fetus (PHMCF) is a very rare clinical condition. It presents with various complications like preterm labor, pre-eclampsia, hyperthyroidism and fetal anomalies.

Case Presentation: We report the case of a 40-year-old G13P10A2 mother who was referred to our hospital at 28 weeks as a case of twin pregnancy and pre-eclampsia. Read More

Acta Obstet Gynecol Scand 2022 Jun 11. Epub 2022 Jun 11.

Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

Introduction: Treatment with antibodies directed against programmed-cell death ligand 1 (PD-L1) is a novel therapy for patients with gestational trophoblastic disease. Assessment of PD-L1 expression in tumor tissue is commonly used to identify patients who might benefit from anti-PD-L1 treatment. Multiple antibodies are available to detect PD-L1-expressing cells, and percentages of PD-L1-expressing cells in samples of patients with gestational trophoblastic disease indicated by these antibodies differ substantially. Read More

Minerva Obstet Gynecol 2022 Jun;74(3):308-313

Prenatal Medicine Unit, Service of Obstetrics and Gynecology, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy -

Molar degeneration of the trophoblast is a rare, yet possible, complication of pregnancies. Complete hydatidiform mole is the most common histological type among all trophoblastic tumors and it is the result of the fertilization of an empty oocyte from two sperms or by one sperm that then duplicates. Complete mole is characterized by hydropic degeneration of abnormal chorionic villi, diffused trophoblast hyperplasia and the absence of identifiable embryonic or fetal tissue; the hyperplastic trophoblast justifies the common finding of high serum beta HCG levels. Read More

J Turk Ger Gynecol Assoc 2022 06;23(2):83-94

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesk, India

Objective: Molar pregnancy coexistent with a live fetus can be a diagnostic and therapeutic challenge. With increasing incidence of multiple pregnancies, there has also been an increase in twin pregnancy with one mole in the recent years. The authors discuss the epidemiology, clinical presentation, and prenatal diagnosis and attempt to design a possible management strategy, to help guide the treating physician, in the management of partial mole with live pregnancy, thereby improving maternal and fetal prognosis. Read More

Eur J Obstet Gynecol Reprod Biol 2022 Jul 25;274:136-141. Epub 2022 May 25.

Department of Obstetrics and Gynecology, Galilee Medical Cente, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.

Objective: Molar pregnancy is the most common type of gestational trophoblastic disease. Several recent reports have described changes in the clinical representation, the incidence and the diagnostic sensitivity of molar pregnancy. These changes could be due to widespread use of transvaginal ultrasound and beta-hCG testing in the management of routine first-trimester investigations. Read More

Ann Med Surg (Lond) 2022 May 21;77:103659. Epub 2022 Apr 21.

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Jendral Soedirman - Prof. Dr. Margono Soekarjo Hospital, Purwokerto, Indonesia.

Introduction: The management of a large uterine fibroid concurrent with gestational trophoblastic disease (GTD) in a nullipara is complicated, challenging yet should focus on conserving fertility. We would like to share our experience.

Case Description: A 28-year-old G1P0A0 of 10-11 weeks' gestation presented with a profuse vaginal bleeding with a history of passing swollen, grape-like tissues from the vagina. Read More

Nutr Cancer 2022 May 27:1-8. Epub 2022 May 27.

Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.

The current ecological study aims to explore the association between dietary factors and hydatidiform mole (HM) incidence in Japan and China. HM incidence in Japan gradually declined from 1970s to 1990s, while the dietary structure also changed during the same period, mainly characterized by a decrease in the consumption of cereals and an increase in the consumption of meat, eggs, and dairy products. In China, HM incidence varied by regions, and it positively correlated with the per capita intake of rice, fish and shrimp, and animal fat, as well as the proportion of GDP of primary industry; and negatively correlated with the per capita intake of wheat flour, starch and sugar, protein, and iron, and the proportion of protein in the caloric nutrients and the proportion of nonagricultural population. Read More

Taiwan J Obstet Gynecol 2022 May;61(3):453-458

Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, PR China. Electronic address:

Objective: To evaluate the obstetrical and oncological progression of twin pregnancies with hydatidiform mole coexisting fetus (HMCF).

Materials And Methods: Using a retrospective method based on patients from the Women's Hospital, Zhejiang University School of Medicine database between January 1990 and October 2020, 17 patients were histologically confirmed as having HMCF, and the patients' prenatal diagnosis, outcomes and development of gestational trophoblastic neoplasia (GTN) were reviewed.

Results: Among these 17 cases, 11 (64. Read More

J Obstet Gynaecol Can 2021 Jun 29. Epub 2021 Jun 29.

Hereford County Hospital, Hereford County Hospital, Stonebow Road, HR1 2ER.

BMJ Case Rep 2022 May 18;15(5). Epub 2022 May 18.

Obstetric and Gynaecology, Sarawak General Hospital, Kuching, Sarawak, Malaysia.

Gestational trophoblastic neoplasm (GTN) in end-stage renal failure (ESRF) has not been reported. We reported an unprecedented case of GTN in ESRF from an antecedent partial mole. She had total abdominal hysterectomy and bilateral salpingectomy following the diagnosis as the disease was confined to the uterus. Read More

Clin Epigenetics 2022 05 17;14(1):64. Epub 2022 May 17.

Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.

Background: Placental mesenchymal dysplasia (PMD) is a morphological abnormality resembling partial hydatidiform moles. It is often associated with androgenetic/biparental mosaicism (ABM) and complicated by Beckwith-Wiedemann syndrome (BWS), an imprinting disorder. These phenomena suggest an association between PMD and aberrant genomic imprinting, particularly of CDKN1C and IGF2. Read More

Case Rep Womens Health 2022 Jul 27;35:e00417. Epub 2022 Apr 27.

Department of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, 2-1 Toyochi Kamiyajiro, Shirakawa, Fukushima 961-0005, Japan.

Hydatidiform moles can be fatal because of the risk of massive bleeding or thyroid storm; however, they rarely occur concomitantly with sepsis. We present herein the case of a woman with a hydatidiform mole with septic shock. A 30-year-old multiparous woman with Basedow's disease presented with fever, amenorrhea, and vaginal bleeding. Read More

Reprod Biomed Online 2022 Mar 23. Epub 2022 Mar 23.

Invitae, San Francisco CA, USA. Electronic address:

Research Question: What is the genetic cause of sporadic and recurrent pregnancy loss and does the frequency and nature of chromosomal abnormalities play a role? Types and frequency of all identifiable chromosomal abnormalities were determined to inform our understanding, medical management and recurrence risk for patients experiencing pregnancy loss.

Design: Genome-wide single-nucleotide polymorphism-based chromosomal microarray (SNP-CMA) were used to evaluate 24,900 products of conception samples from various forms of pregnancy losses.

Results: Sporadic miscarriage (64. Read More

Int J Gynecol Pathol 2022 Apr 12. Epub 2022 Apr 12.

Autophagy is implicated in normal pregnancy and various pathologic pregnancy conditions. Its presence in hydatidiform moles (HM) is unknown. We immunohistochemically studied 36 HM for LC3B and p62 to precisely determine their expression in the decidua, endometrium, and villi. Read More

Int J Gynecol Cancer 2022 Apr 29. Epub 2022 Apr 29.

Gynecology and Obstetrics, University of Liege Central University Hospital, Liège, Belgium

Objective: To evaluate the added value of a centralized pathology review of the diagnoses of gestational trophoblastic diseases by expert pathologists and its potential impact on clinical management in a prospective multicenter study based on the Belgian Gestational Trophoblastic Diseases Registry.

Methods: From July 2012 to December 2020, the two referral centers of the registry were solicited to advise on 1119 cases. Referral pathologists systematically reviewed all of the initial histological diagnoses. Read More

Reproduction 2022 04 22;163(6):351-363. Epub 2022 Apr 22.

Scientific Laboratory of Molecular Genetics, Riga Stradins University, Riga, Latvia.

Genetic testing is becoming increasingly required at almost every stage of failed female reproduction/infertility. Nonetheless, clinical evidence for the majority of identified gene-disease relationships is ill-defined, thus leading to difficult gene variant interpretation and poor translation of existing knowledge into clinics. We aimed to identify the genes that have ever been implicated in monogenic female reproductive failure in humans and to classify the identified gene-disease relationship pairs using a standardized clinical validity assessment. Read More

Arkh Patol 2022 ;84(2):44-50

Scientific Research Centre for Medical Genetics, Moscow, Russia.

The case of dichorionic twin pregnancy is described, with a fused placenta, one part of which is represented by a tissue of partial hydatidiform mole (PHM) with signs of regression, the second part is a placenta of a common structure with a normal development of the second twin. The delivery took place at the term of 38 weeks with a live healthy girl weighing 3250 g. A single placental disc consisted of two fused placentas with a clear boundary between them. Read More

Semin Diagn Pathol 2022 May 22;39(3):228-237. Epub 2022 Mar 22.

Department of Pathology, UT Southwestern Medical Center, 5200 Harry Hines Blvd, Room 02-621 Dallas, TX, 75235, USA. Electronic address:

Gestational trophoblastic disease (GTD) is a heterogeneous group of lesions that are characterized by the abnormal proliferation of the trophoblast. Morphology, behavior and clinical significance vary tremendously and range from benign, non-neoplastic lesions that cause sometimes dysfunctional uterine bleeding to aggressive, highly, malignant tumors. The recently updated 2020 World Health Organization (WHO) Classification of Female Genital Tumors divides GTD in molar pregnancies/ hydatidiform moles, gestational trophoblastic neoplasms, tumor-like lesions and abnormal (nonmolar) villous lesions. Read More

Int Health 2022 Apr 8. Epub 2022 Apr 8.

Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, University of Dodoma, 295 Dodoma, Tanzania.

Background: Gestational trophoblastic diseases (GTDs) may follow any form of pregnancy or a pregnancy loss. Early detection of GTDs is important, as some benign forms of the disease may progress into a chemoresistant and metastatic disease. This study aimed at determining the frequency of GTDs among women experiencing first trimester pregnancy loss and the associated patients' characteristics. Read More

Eur J Obstet Gynecol Reprod Biol 2022 May 28;272:206-212. Epub 2022 Mar 28.

Department of Obstetrics & Gynaecology, Cork University Maternity Hospital, Ireland; Pregnancy Loss Research Group, The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Ireland.

Objective: Gestational Trophoblastic Disease (GTD) is a rare pregnancy related disorder and the most curable of all gynaecological malignancies. GTD comprises the premalignant conditions of complete or partial hydatidiform mole known as molar pregnancy and a spectrum of malignant disorders termed gestational trophoblastic neoplasia. Clinical management and treatment in specialist centres is essential to achieve high cure rates and clinical guidelines recommend registration with a GTD centre as a minimum standard of care. Read More

Nat Methods 2022 06 31;19(6):687-695. Epub 2022 Mar 31.

Genome Informatics Section, Computational and Statistical Genomics Branch, NHGRI, NIH, Bethesda, MD, USA.

Advances in long-read sequencing technologies and genome assembly methods have enabled the recent completion of the first telomere-to-telomere human genome assembly, which resolves complex segmental duplications and large tandem repeats, including centromeric satellite arrays in a complete hydatidiform mole (CHM13). Although derived from highly accurate sequences, evaluation revealed evidence of small errors and structural misassemblies in the initial draft assembly. To correct these errors, we designed a new repeat-aware polishing strategy that made accurate assembly corrections in large repeats without overcorrection, ultimately fixing 51% of the existing errors and improving the assembly quality value from 70. Read More

Genome Res 2022 04 31;32(4):599-607. Epub 2022 Mar 31.

Department of Genetic Medicine and Development, University of Geneva Medical Faculty, 1211 Geneva, Switzerland.

The complete, ungapped sequence of the short arms of human acrocentric chromosomes (SAACs) is still unknown almost 20 years after the near completion of the Human Genome Project. Yet these short arms of Chromosomes 13, 14, 15, 21, and 22 contain the ribosomal DNA (rDNA) genes, which are of paramount importance for human biology. The sequences of SAACs show an extensive variation in the copy number of the various repetitive elements, the full extent of which is currently unknown. Read More

Taiwan J Obstet Gynecol 2022 Mar;61(2):395-398

Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. Electronic address:

Objective: Hydatidiform mole (HM) is defined by trophoblastic proliferation and vesicular enlargement of placental villi in which, KHDC3L gene plays a causal role.

Case Report: This report presents a clinical review and genetic screening for p.Asp108Ilefs∗30 mutation in KHDC3L gene in an affected woman with a previous history of HM and three siblings with a history of HM. Read More

J Obstet Gynaecol Res 2022 Jun 29;48(6):1458-1465. Epub 2022 Mar 29.

Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.

Aim: We present two cases of triplet pregnancy with complete hydatidiform mole (CHM) in contrasting outcomes and discuss the complications of mothers and outcomes of fetuses through a literature review, raising an important issue on the management of this special pregnancy.

Methods: We share our manage experience for two cases of triplet pregnancy with CHM and retrospectively analyze 18 similar pregnancies reported previously with different pregnancy outcomes.

Results: In our cases, one case receiving Clomiphene ovulation induction delivered two live fetuses by cesarean section at 30+ weeks without GTN (gestational trophoblastic neoplasia), unfortunately, the other case following ICSI-ET terminated the pregnancy in the setting of complications at 18+ weeks without GTN. Read More

Cureus 2022 Feb 15;14(2):e22240. Epub 2022 Feb 15.

Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário do Porto, Porto, PRT.

Gestational trophoblastic disease (GTD) represents a heterogeneous group of disorders within placental trophoblastic cells that are rather rare in perimenopausal ages. One of its complications is the development of secondary clinical hyperthyroidism, which can be potentially complicated if not properly and early recognized. We report the case of a 50-year-old perimenopausal woman, gravida 2 para 2, who presented to the emergency department with severe acute lower abdominal pain and abnormal uterine bleeding for one month. Read More

Int J Gynecol Cancer 2022 05 3;32(5):633-638. Epub 2022 May 3.

Department of Obstetrics, Universidade Federal de São Paulo, Sao Paulo, Brazil.

Background: Telemonitoring is an alternative to in-person appointments and overcomes geographic distance barriers.

Objective: The primary objective of this study was to evaluate adherence to post-molar follow-up using both WhatsApp and in-person appointments compared with standard care. The secondary objective was to evaluate the rate of completion of post-molar follow-up of complete moles, considering 6 and 3 months of duration. Read More

Rom J Morphol Embryol 2021 Jul-Sep;62(3):855-859

Department of Anatomy, Department of Obstetrics and Gynecology, Nicolae Malaxa Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;

Described as a rare anomaly of the placenta, with a reported incidence of 0.02%, mesenchymal dysplasia is a benign condition characterized by placentomegaly, grape-like vesicles and by microscopic features resembling those of a molar pregnancy, such as hydropic villi, cistern formation and dysplastic blood vessels. We report a rare case of placental mesenchymal dysplasia diagnosed in a pregnancy with early symmetric fetal intrauterine growth restriction and a normal karyotype. Read More

Cancer Cell Int 2022 Mar 4;22(1):103. Epub 2022 Mar 4.

Core Lab Glycobiol & Glycoengn, College of Basic Medical Sciences, Dalian Medical University, Dalian, 116044, Liaoning, China.

Background: A hydatidiform mole is a condition caused by abnormal proliferation of trophoblastic cells. MicroRNA miR-30a acts as a tumor suppressor gene in most tumors and participates in the development of various cancers. However, its role in hydatidiform moles is not clear. Read More