The Importance of Early Diagnosis: A Case Report of Uterine Rupture in Molar Pregnancy

Abstract

Gestational trophoblastic disease (GTD) is a heterogeneous spectrum of diseases with abnormal trophoblastic proliferation ranging from benign to malignant state. It has varying degree of spread from local invasion to distant metastasis. These disease are characterized by a reliable tumor marker, which is the b-subunit of human chorionic gonadotropin (b-hCG), and have varied tendencies for local invasion and spread. Benign lesions consist of hydatidiform moles, complete and partial, whereas malignant lesions consist of invasive moles, placental-site trophoblastic tumors (PSTT), epithelioid trophoblastic tumors (ETT), and choriocarcinoma. Although GTNs commonly follow a molar pregnancy, they can occur after any gestational event, including induced or spontaneous abortion, ectopic pregnancy, or term pregnancy. Hydatidiform mole or what is called a molar pregnancy, is histologically characterized by chorionic villous abnormalities consisting of trophoblastic proliferation and villous stromal oedema. The incidence of hydatidiform mole is increasing every year. It may be categorized as either complete or partial moles on the basis of gross morphology, histopathology, and karyotype. The classical presenting symptoms and signs of patients with complete and partial molar pregnancy are vaginal bleeding, excessive uterine size, and sign of toxemia. Ultrasonography has replaced all other radiographic means for diagnosis of hydatidiform mole. Molar tissue typically is identified as a diffuse mixed echogenic and vesicular pattern replacing the placenta.