True about complete hydatidiform mole is :
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Ans. is a, b and c i.e. Chromosome pattern is XX; Enlarged ovarian cyst occurs; and Associated with preeclampsia The incidence of H. mole is maximum in oriental and south east countries (maximum incidence is in Philippines: 1 in 80 pregnancies) Le., it is more common in developing countries option 'a ruled out). H, mole can be categorized as either complete or paial mole on the basis of Gross morphology, histopathology and karyotype. Complete H. mole - shows no evidence (If fetal tissue at all, Complete hydatiform moles exhibit characteristic swelling and trophoblastic hyperplasia. Most common karyotype is 46XX (10% may have a 46XY karyotype). The molar chromosomes are entirely of paternal origin, although mitochondrial DNA is of maternal origin. The complete moles arises from an ovum that has been feilized by a haploid sperm, which then duplicates its own chromosomes called as Androgenesr. The ovum nucleus may be either absent or inactivated. Clinical features; Symptoms: Amenorrhea of varying duration followed by continuous or intermittent brown or bloody discharge (usually not profuse) evident by - 12 weeks. Passage of vesicles per vaginum Hyperemesis (due to the high levels of circulating HCG). Signs: Uterus: - The fundal height of uterus is more than the period of amenorrhea in 50% cases. In 35% it corresponds to the gestational period and in the rest it may be smaller. - Uterus is doughy in consistency (due to absence of amniotic fluid). - Fetal pas will not be felt. - Fetal hea sounds will not be heard (even on doppler). - External and internal ballottement can not be elicited. Theca lutein cysts : - May be felt in the ovaries in about 25 to 60%. - Due to overstimulation of the luteal elements by the large amounts of circulating HCGdeg - Persistent trophoblastic disease is more likely in women with theca lutein cysts. Early onset preeclampsia - When hypeension appears before 24 weeks, it is impoant to rule out hydatidiform mole. Thyrotoxicosis seen due to the thyrotrophin-like effect of HOG.deg Spontaneous expulsion occurs at around 18 weeksdeg and rarely delayed beyond 28 weeks.deg Characteristics of paial H. mole Some embryonic or fetal tissue identifiable. Paial moles generally have a triploid karyotype (69 chromosomes); the extra haploid set of chromosomes usually is derived from the father Chorionic villi of varying size with focal hydatidiform swelling, cavitation, and trophoblastic hyperplasia whereas complete mole shows diffuse hydatidiform swelling and trophoblastic hyperplasia. Marked villous scalloping. Prominent stromal trophoblastic inclusions. - When a fetus is present in conjunction with a paial mole. it generally exhibits the stigmata of triploidy, including growth retardation and multiple congenital malformations such as syndactyly and hydrocephaly.
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