Mola hidatidosa ditandai oleh kelainan vili korialis, yang terdiri dari proliferasi trofoblastik dangan derajat yang bervariasi dan edema sroma vilus. Klasifikasi mola hidatidosa secara klinikopatologi dibagi menjadi dua yaitu mola komplit dan mola parsial. Kami menyadari bahwa dalam menyusun tugas makalah ini kami banyak menumukan berbagi hambatan ataupun kesulitan. Prognosis skor 7 dianggap memiliki risiko yang tinggi. Molar pregnancy is an abnormal form of pregnancy in which a nonviable fertilized egg implants in the uterus and will fail to come to term. Ditandai dengan gambaran seperti sekelompok buah anggur. Because of early diagnosis and appropriate treatment, the current. Definitions gestational trophoblastic disease gtd forms. Gtn was diagnosed according to the figo 2000 criteria i. Diagnosis, classification and treatment of gestational. Di negaranegara timur jauh beberapa sumber memperkirakan insidensi mola lebih tinggi lagi yakni 1. Rahim menjadi lunak dan berkembang lebih cepat dari usia kehamilan yang normal, tidak dijumpai adanya janin, dan rongga rahim hanya terisi oleh jaringan seperti. The name hydatidiform mole comes from the greek words hydatisia which means drop of water and mola which means false conception. Mola hidatidosa merupakan hasil konsepsi tanpa adanya embrio.
Daftar pustaka cunningham fg, lenevo kj, bloom sl, et al. Mola hidatidosa hamil anggur sebab, gejala, patologi. For genotyping, genomic dna was extracted from separate microdissected fractions of. Kariotipe pada mola hidatidosa parsial adalah 90% triploid yaitu 69,xxx atau 69,xxy.
Prognosis after removal, the prognosis is excellent. Bila ada kehamilan kembar yang salah satunya adalah mola penting sekali untuk membedakannya apakah itu suatu mola komplit atau mola parsial. Manual compared with electric vacuum aspiration for treatment of. Feb 16, 2018 a study by gadducci et al indicated that women with gestational trophoblastic neoplasia have a good prognosis and that such women who conceive after chemotherapy have similar obstetric outcomes to those of the general population. Despite the undoubted effectiveness of chemotherapeutic treatment in gestational trophoblastic neoplasia gtn, problems related to toxicity of chemotherapy and chemoresistant disease have led to reconsideration of the use of hysterectomy. Simultaneous occurence of mola hydatidosa destruens and cervical cancer. The incidence of hydatidiform mole in the united states and other developed countries is about 1 in 1500 live births 1. Approximately 20% of women with a complete mole develop a trophoblastic malignancy. Mikroskopik tampak edema stroma vili tanpa vaskularisasi disertai. In the study, 18 of 66 patients with hydatiform mole developed gestational trophoblastic neoplasia and two women. Oleh karena itu, prognosis dari penyakit ini biasanya baik dengan penanganan yang tepat. A molar pregnancy is a gestational trophoblastic disease which grows into a mass in the uterus that has swollen chorionic villi.
Sep 16, 20 janin dapat mengalami abortus namun kadang kadang berkembang sampai aterm. Of these, spontaneous abortion or later evacuation because of missed abortion 101 histo. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Gestational trophoblastic disease gtd is a rare complication of pregnancy that may be associated with thyrotoxicosis. Scribd is the worlds largest social reading and publishing site. Abortus mola lakukan evakuasi dengan menggunakan suction curettagedan kosongkan isi uterus secara cepat. Pdf the controversy of hydatidiform mole treatment in women. Pada kondisi ini embrio tidak berkembang, mola dapat diidentifikasikan menjadi choriocarsinoma, jika berkembang dengan cepat dan menjadi ganas.
Hydatiform mola definition of hydatiform mola by medical. A hydatidiform mole hydatid mole, mola hydatidosa is a placental mass resulting from the proliferation of the trophoblast, with hydropic degeneration and avascularity of the chorionic villi. Because of early diagnosis and appropriate treatment, the current mortality rate from hydatidiform mole is essentially zero. The ultrasound investigation revealed no signs of intrauterine life in 110 patients. Hydatidiform mole definition a hydatidiform mole is a relatively rare condition in which tissue around a fertilized egg that normally would have developed into the placenta instead develops as an abnormal cluster of cells. Kata pengantar puji syukur kami panjatkan kepada tuhan yang maha esa, karena dengan kasih dan karunianya kami dapat menyelesaikan tugas makalah askeb iv yang berjudul mola hidatidosa hamil anggur dengan baik dan semaksimal mungkin. Selsel tersebut berdegenerasi dan telah berisi dengan cairan, gelembunggelembung tersebut berukuran seperti buah anggur. Mola hidatidosa adalah poliferasi dan degenerasi dari villi trofoblas.
The main risk is retention by incomplete aspiration 25% of cases justifying ultrasound followup within 15 days of aspiration. Aim of the present study was to evaluate indications for and outcome of hysterectomy in patients with gtn in a nationwide cohort. Sel trofoblas hanya ditemukan pada wanita hamil, apabila ditemukan pada wanita tidak hamil pada teratoma ovarium disebut non gestasional trophoblastic disease. Rozlisujeme mola hydatidosa partialis, mola hydatidosa completa, mola hydatidosa proliferans a choriokarcinom. This is reported to occur in 4% of patients diagnosed at 59 weeks of gestation, and in 23% when the diagnosis is made after 10 weeks gestation. In the uk, there exists an effective registration and treatment programme. This is due to extremely high levels of human chorionic gonadotropin hcg. About omics international omics international through its open access initiative is committed to make genuine and reliable contributions to the scientific community. The molar pregnancy is diagnosed after a routine pregnancy ultrasound scan see below. The added value of hysterectomy in the management of.
Number of recovered nodes has been reported to correlate with better prognosis, likely due to more accurate staging metastasis to nonregional lymph nodes outside of the drainage area of the tumor, i. Molecular genetic studies of complete hydatidiform moles. Request pdf a mola hydatidosa coexistent with a foetus in a bovine freemartin pregnancy molar transformations of the bovine placenta are extremly rare phenomenona and the aetiology of this. Mola hidatidosa parsial biasanya triploid, dengan satu maternal dan dua paternal haploid yang berasal dari fertilisasi dispermik maupun fertilisasi dengan sperma diploid yang tidak tereduksi. Dark brown to bright red vaginal bleeding during the first trimester. Feb 16, 2018 patients may also report severe nausea and vomiting. Kehamilan mola hidatidosa mola hydatidosa askeb iv. Pathology outlines tnm staging of colorectal carcinoma. Urinalysis is necessary to identify proteinuria or to quantify the amount of protein excretion in the 24hour urine. If this does not happen, however, a vacuum aspiration can be performed to remove the mole. Apr 02, 2015 mola hidatidosa ialah kehamilan abnormal, dengan ciriciri tumor jinak benigna dari chorion penyebab embrio mati dalam uterus tetapi plasenta melanjutkan selsel trophoblastik terus tumbuh menjadi agresif dan membentuk tumor yang invasif, kemudian edema dan membentuk seperti buah anggur, karakteristik mola hidatiosa bentuk komplet dan bentuk parsial, yaitu tidak ada jaringan embrio dan ada. Hasil konsepsi pada kehamilan mola tidak berkembang menjadi embrio setelah pembuahan tetapi terjadi villi koriales disertai dengan degenerasi hidropik.
Clinicians need to be aware of the symptoms and signs of molar pregnancy. Apr 29, 20 di negaranegara timur jauh beberapa sumber memperkirakan insidensi mola lebih tinggi lagi yakni 1. Retention ultrasound image of more than 17 mm in anteroposterior diameter warrants a repeated aspiration. Prognosis prognosis mola hidatidosa umumnya baik risiko untuk kejadian mola hidatidosa berulang adalah 1. Janin dapat mengalami abortus namun kadang kadang berkembang sampai aterm. Treatment involves surgical removal of the molar pregnancy followed by. Kehamilan mola merupakan komplikasi dan penyulit kehamilan pada trimester satu. Feb 02, 2015 complete hydatidiform moles chm have no identifiable embryonic or fetal tissues and result from an abnormal growth of trophoblastic cells that would otherwise normally develop into the placenta. It replaces the management of gestational trophoblastic neoplasia, which was published in 2004. Mola hidatidosa dapat digolongkan sebagai tumor jinak, bukan suatu keganasan sel kanker. Sedangkan klasifikasi dari penyakit trofoblas gestasional ini secara keseluruhan yaitu.
A study by gadducci et al indicated that women with gestational trophoblastic neoplasia have a good prognosis and that such women who conceive after chemotherapy have similar obstetric outcomes to those of the general population. A molar pregnancy is a rare complication that happens when tissue inside the uterus becomes a mass or tumor. Resiko untuk berkembang menjadi tumor trofoblas dari mola sekitara 20 %. The ultrasound diagnosis of a partial molar pregnancy is more complex. May 16, 2012 kehamilan mola merupakan komplikasi dan penyulit kehamilan pada trimester satu. A mola hydatidosa coexistent with a foetus in a bovine. Dec 14, 2017 a molar pregnancy may seem like a normal pregnancy at first, but most molar pregnancies cause specific signs and symptoms, including. Hal hal yang berpengaruh terhadap mola hidatidosa 2. Mola hidatidosa adalah perubahan abnormal dari villi korionik menjadi sejumlah kista yang menyerupai anggur yang dipenuhi dengan cairan. Webmd explains what the symptoms are and how its diagnosed and treated.
Patients may also report severe nausea and vomiting. Incidence rate in the united states and europe is between 1 in 1,000 and 1 in 2,000 pregnancies. Pada sebagian kecil kasus, walaupun jarang terjadi, mola hidatidosa dapat berkembang ke arah keganasan menjadi sel kanker choriocarcinoma. The management of gestational trophoblastic disease rcog. Pdf hydatidiform mole is the most common form of gestational trophoblastic disease. This grapelike mass forms inside of the uterus after fertilization instead of a normal. Diagnostic ultrasound in threatened abortion and suspected. A molar pregnancy can develop when a fertilized egg does not contain an. Simultaneous occurence of mola hydatidosa destruens and. Ultrasound diagnosis of partial mole is more difficult. Mola pasang batang laminaria selama 24 jam untuk mendilatasi serviks. Women over the age of 30 and especially those over 40 years are at increased risk.
Mola hidatidosa merupakan bagian dari penyakit tropoblas dan dimasukan dalam gestasional trophoblastic disease. Measurements of ast, alt and ldh enzymes are performed in order to identify liver involvement. If you have a molar pregnancy, further testing will be done to determine the type of mole and the possibility of it having spread outside the uterus. Mola hidatidosa ialah kehamilan abnormal, dengan ciriciri tumor jinak benigna dari chorion penyebab embrio mati dalam uterus tetapi plasenta melanjutkan selsel trophoblastik terus tumbuh menjadi agresif dan membentuk tumor yang invasif, kemudian edema dan membentuk seperti buah anggur, karakteristik mola hidatiosa bentuk komplet dan bentuk parsial, yaitu tidak ada jaringan. Setelah serviks terbuka, lanjutkan tatalaksana seperti abortus mola. Molar an abnormaly pregnancy, which partial or pregnancy completely of corrialis villi undergoes a hydrophic degeneration like grape. Persistent tumor, usually nonmetastatic, develops in approximately 24% of patients with a partial mole, and chemotherapy is required to achieve remission. Nov 01, 2016 some women with a hydatidiform mole have no symptoms. Complete hydatidiform moles chm have no identifiable embryonic or fetal tissues and result from an abnormal growth of trophoblastic cells that would otherwise normally develop into the placenta. Hydatidiform moles are one of the common complications of gestation, estimated to occur in one of every 1,0002,000 pregnancies 3 these moles can occur in a pregnant woman of any age, but the rate of occurrence is higher in pregnant women in their teens or between the ages of 4050 years. Pdf hydatidiform mole is the most common form of gestational. Fortunately, the present patient had remission after the. Penanganan mola hidatidosa tidak terbatas pada evakuasi kehamilan mola saja, tetapi juga membutuhkan penanganan lebih lanjut berupa monitoring untuk memastikan prognosis penyakit tersebut.
Rahim menjadi lunak dan berkembang lebih cepat dari usia kehamilan yang normal, tidak dijumpai adanya janin, dan rongga rahim hanya terisi oleh jaringan. The management of gestational trophoblastic disease this is the third edition of this guideline. Pada trimester kedua mola terlihat sebagai jaringan lunak kurang ekhogenik yang dikelilingi masa yang lebih ekhogenik. A combination of clinical, laboratory and imaging data raises the possibility of molar pregnancy poor interobserver agreement in differentiating between complete mole, incomplete mole and hydropic abortus when using histology alone, with discordance predominantly seen in partial mole vs. Some women with a hydatidiform mole have no symptoms. Pada umumnya kehamilan diharapkan berakhir dengan sempurna tetapi sering kali terjadi kegagalan, maka. Mola hydatidosa merupakan kehamilan patologis yang ditandai dengan pembesaran vili plasenta atau vili korialis. Bezne by invaze trofoblastu mela zanikat do 30 dnu po ukonceni tehotenstvi porod, potrat, ektopicka gravidita. Normal and abnormal early pregnancy article pdf available in donald school journal of ultrasound in obstetrics and gynecology 54. Pada trimester pertama mola memiliki gambaran seperti blighted ovum atau bisa terlihat sebagai masa ekhogenik yang avaskuler. Berikan uterotonika sesaat sebelum dimulai proses evakuasi mola. Urinalysis is necessary to identify proteinuria or to quantify the. The management of gestational trophoblastic disease. Very rarely, you may have problems with high blood pressure, very bad nausea and vomiting hyperemesis gravidarum or symptoms of an overactive thyroid gland may develop.
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