Gestational Trophoblastic Disease

Question No. 12. The Answer is: (D) Presence of fetal parts is not generally compatible with complete moles.

Discussion: Complete hydatiform mole(CHD) is a hyperplastic process characterized by increased trophoblastic proliferation either due to overexpression of paternally derived genes or an underexpression of maternally derived genes;this greatly influenced by genetic imprinting. Complete mole are usually diploid, while partial moles are often triploid. The “snow storm” radiographic appearance refers to the multiple, grape-like enlarged edematous villi seen in late moles which present with such classic clinical features as a uterus too large for dates, vaginal bleeding, or greatly elevated serum hCG. Early complete moles are often diagnosed after an evacuation procedure for lack of apparent intrauterine fetus by ultrasound, with subsequent careful microscopic examination. The presence of fetal parts is usually associated with partial moles. There is no evidence that complete moles derive from partial moles and is unlikely due to the known pathogenesis of both entities.

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