False about paial mole
Ans. is b i.e. can be diagnosed very early by USG Paial moles Paial moles or incomplete molar pregnancy means that along with the hydatidiform changes some element of fetal tissue is present They have a triploid karyotype (69 chromosomes)deg, the extra haploid set of chromosomes usually is derived from the fatherdeg. Characteristic pathological features of paial mole Chorionic villi of varying sizes with focal hydatiform swelling, cavitation and trophoblastic hyperplasia Marked villous scalloping Prominent stromal trophoblastic inclusions Identifiable embryonic or fetal tissue. Clinical features -- hey generally do not have the dramatic clinical features characteristic of complete pt general these patients have the signs and symptoms of incomplete or missed aboion, and paial mole can be diagnosed after histologic review of tissue obtained by curettage". Features like hyperemesis, hypehyroidism and Theca lutein cysts are rare in paial mole. Prognosis "The risk of persistent trophoblastic disease after a paial mole is substancially lower than following a complete molar pregnancy. Moreover, persistent disease is seldom a choriocarcinoma." The risk of persistent trophoblastic disease in a case of paial mole is 1-5% wherease with complete mole, it is 15-20% Hence option d i.e. it rarely causes persistent trophoblatic disease is paially correct Diagnosis -- of paial mole by USG is not that easy as is in the case of complete mole because it does not give the characteristic vesicular & ultrasonographic appearance like a complete mole. "Sonographic features of a paial mole include a thickened, hydropic placenta with fetal tissue. Impoantly, in early pregnancy, sonographv will demon t te the rho raeristic appearance in as few as third of women with a paial mole" ... Williams Obs 23/ed pg-260 Hence Option b i.e. it can be diagnosed very early by USG is incorrect Remember - - The USG criteria for diagnosis of paial mole is Presence of focal cystic areas in the placental tissues . Increase in transverse diameter of gestational sac. The combination of above two criterias have a positive predictive value of 90% for paial moles . (This means USG can diagnose paial mole but not in early pregnancy) The nonble fetus associated with a triploid paial mole typically has multiple malformations, like syndactyly and hydrocephaly and have symmetrical growth retardation. 13 hcg levels > 200 m IU/rni, after evacuation of paial mole in the third through the eighth week are associated with a 35% risk of persistent trophoblastic disease. Extra edge The most significant recent development in the pathological analysis of H. mole is the use of P57kip2 immunostaining to make a definitive diagnosis of androgenetic complete H. Mole as opposed to an hydropic aboion or a paial mole. P57kip2 is a paternally imprinted gene. which is maternally expressed. The absence of maternal genes in androgenetic complete mole means that the gene cannot be expressed in a complete mole cytotrophoblast Hence V kip2 staining is negative in complete mole in contrast to paial moles, hydropic aboion & normal placenta. This technique is well validated, easy and inexpensive to perform.
Caused by triploidy
Can be diagnosed very early by USG
Can present as missed aboion
Rarely causes persistent GTD