Medicine an Surgery notes

Apr 24th, 2015
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GestationalTrophoblasticDiseasesDr Njoroge Waithaka1DefinitionThese are diseases arising fromthe trophoblastic tissue.The trophoblastic tissue consist ofsynciotrophoblast andcytotrophoblast2Types of GTDs1.2.3.4.Hydatidiform MoleInvasive MoleChoriocarcinomaPlacental Site Tumor3IncidenceHydatidiform Mole is thecommonest of these diseases.In Taiwan the incidence is 1:125deliveriesUSA 1:1500 deliveriesKenya 1:370 deliveriesThe incidence of choriocarcinomain Kenya is 1: 8474Associated FactorsMore common at ages below 20yrs andabove 40yrsLow socioeconomic statusLow protein and low folic acid dietsOccur in less than 5%of subsequentpregnancyA blood group A woman with a group Ospouse has a x10 higher riskBlood group AB have a poor prognosis5In choriocarcinoma:50% follow Hmole25% follow abortion25%follow term pregnancy6classificationHydatidiform Mole (True Molar) abnormal pregnancycharacterized by multiple grapelikevesicles filling and distending the uterusin absence of an intactfetus.chromosome are paternal 46xxPartial Mole occurs when the placentahas molar transformation in the 2nd or3rd trimester in presence of a fetus7microscopyThere is edema of the villi stroma,avascular villi,nests of proliferatingsynciotrophoblast andcytotrophoblast elementssurrounding the villi. The likelyhood of malignant transformation

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