Gestational Trophoblastic Disease: Understanding Hydatidiform Mole

Gestational trophoblastic disease (GTD) encompasses a range of disorders originating from abnormal trophoblastic proliferation. Among these, hydatidiform mole is the most recognized and classified into complete and partial types.

Classification of Hydatidiform Mole

• Complete Mole: Characterized by the absence of fetal tissue and diploid chromosomal composition, usually 46XX derived from paternal origin.
• Partial Mole: Contains some fetal tissue and has a triploid chromosomal pattern (69XXX, 69XXY, or 69XYY).

Pathophysiology

The condition results from aberrant fertilization, leading to excessive trophoblastic growth. Complete moles exhibit significant hCG elevation, predisposing to gestational trophoblastic neoplasia.

Diagnosis

Key diagnostic approaches include:

• Ultrasound showing a ‘snowstorm’ pattern in complete moles.
• Elevated beta-hCG levels disproportionate to gestational age.
• Histopathological examination confirming trophoblastic hyperplasia.

Management and Prognosis

Early identification through ultrasound and serum hCG monitoring facilitates effective management. Most cases respond well to evacuation procedures with serial hCG monitoring.