ECON 546 Lecture Notes - Lecture 15: Cytokine, Cytoskeleton, Macrophage
27 Jun 2018
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BIOL 568 – Slim L15: 27/2/18
L15: The Genetics of Recurrent Hydatidiform Moles
HM: rare mass or growth that forms inside the uterus at the beginning of a pregnancy.
Ultrasound and gross morphology of complete hydatidiform mole
oNormal: 6-8 weeks – gestational sac, fetal pole, heart activity seen = healthy
oHM: no gestational sac. Dark spots = echogenic – no tissues. Pregnancy hormone test – very
high inviable pregnancy.
Remove product of conception – chorionic villi of the placenta with accumulated fluid
inside (slide 3). No fetus
Histopathological classification of HM
Complete HM (CHM):
oAbsence of embryo and extraembryonic tissues
oHydropic chorionic villi with no fetal RBC
oExcessive circumferential trophoblastic proliferation – crucial. Must see more than what is
seen in normal pregnancy. Gestational tumours
Partial HM (PHM):
oPresence of embryonic tissues or a full embryo
oMixture of hydropic and normal appearing villi
oMild trophoblastic proliferation
Histopathology:
oNormal pregnancy: cells natural inside villi. Start of formation of fetal vessels. RBCs inside
vessels – fetal circulation has started
oHM: empty – accumulated fluid and all cells inside degenerate.
oTwo layers: internal = cytotrophoblast; outer = syncytiotrophoblast
Several Forms of HM:
a) Sporadic, not recurrent: occur one time. Seen in unrelated pregnancies. 1/600 pregnancies in
Westerns societies, 2-10x higher elsewhere
b) Recurrent moles: 1-6% of all moles
c) Familial Mendelian form: rare
Karyotype and genotype data of common sporadic, non-recurrent HM:
CHM diploid:
omost androgenetic, no maternal genome. Only two copies of the paternal gene.
o85% cases monosperimic. One sperm fertilises oocyte and duplicated its genome
o15% dispermic. Two different alleles at many makers
PHM triploid:
1
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Document Summary
Hm: rare mass or growth that forms inside the uterus at the beginning of a pregnancy. Ultrasound and gross morphology of complete hydatidiform mole: normal: 6-8 weeks gestational sac, fetal pole, heart activity seen = healthy, hm: no gestational sac. Pregnancy hormone test very high inviable pregnancy. Remove product of conception chorionic villi of the placenta with accumulated fluid inside (slide 3). Complete hm (chm): absence of embryo and extraembryonic tissues, hydropic chorionic villi with no fetal rbc, excessive circumferential trophoblastic proliferation crucial. Must see more than what is seen in normal pregnancy. Partial hm (phm): presence of embryonic tissues or a full embryo, mixture of hydropic and normal appearing villi, mild trophoblastic proliferation. Histopathology: normal pregnancy: cells natural inside villi. Rbcs inside vessels fetal circulation has started: hm: empty accumulated fluid and all cells inside degenerate, two layers: internal = cytotrophoblast; outer = syncytiotrophoblast. Several forms of hm: sporadic, not recurrent: occur one time.
