Abstract
Invasive mole (IM) is one of the Gestational trophoblastic neoplasia lesions, characterized by local invasion of trophoblastic with rare distal spread. It could follow any type of pregnancy and commonly arising from a complete hydatidiform mole (CHM). Pathogenesis of hydatidiform mole due to an underlying oocyte defect. Embryos are examined for triploidy to exclude dispermic fertilization in assisted reproduction technology (ART). Besides, several potential mechanisms and risk factors had been described to explain gestational trophoblastic neoplasia (GTN) following ART.
Highlights
Gestational trophoblastic disease (GTD) comprises a group of inter related diseases including premalignant and malignant conditions
assisted reproduction technology (ART) will not eliminate the risk of development of Gestational trophoblastic disease after several precautions are taken to prevent an embryo with triploidy
Invasive mole (IM) is a common manifestation of gestational trophoblastic neoplasia (GTN) characterized by the presence of chorionic villi associated with excessive trophoblastic overgrowth and rare distal invasion to the adjacent structures [2]
Summary
Gestational trophoblastic disease (GTD) comprises a group of inter related diseases including premalignant and malignant conditions. A 40-years-old woman with primary subfertility for ten years became pregnant following successful treatment with ART (ICSI) Her pregnancy continued with dichorionic diamniotic twins, complicated with gestational diabetes mellitus and Hypertensive disorder in pregnancy. She developed a major postpartum haemorrhage treated with uterotonics and blood transfusion and postoperative ICU care. She was discharged on day 10 of postpartum with a good recovery. Ultrasound scan was highly suggestive of an invasive mole which was confirmed by MRI chest, abdomen and pelvis without local invasion or distant metastasis (Figure 1 and Figure 2) She was reviewed by a clinical oncologist and was treated with nine cycles of multi-agent chemotherapy.
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