Literature DB >> 34007656

Management of Partial Hydatidiform Mole and Subsequent Intrauterine Adhesions: A Case Report and Literature Review.

Dor Partosh1, Genevieve Hale1.   

Abstract

BACKGROUND: Gestational trophoblastic disease (GTD) originates from placental tissue and is among rare human tumors that can be cured even in the presence of widespread metastases. The most common form of GTD is hydatidiform mole (HM), commonly referred to as molar pregnancy. Molar pregnancies have the potential to locally invade the uterus and metastasize and result as a result ofgestational trophoblastic neoplasia. Intrauterine adhesions (IUAs) is a condition where scar tissue develops within the uterine cavity, often following a procedure. Hysteroscopy has been established as the criterion standard for the diagnosis of IUAs, although the optimal adjuvant treatment after surgical intervention remains unclear. ‎. CASE: A 35-year-old-female underwent suction curettage a week after the detection of a molar pregnancy. Two months later, she suffered from amenorrhea and hormonal therapy was initiated. Saline-infusion sonogram was tried and failed due to cervical stenosis. IUAs leading to scar tissue developed along with uterine polyps. Hysteroscopy successfully lysed IUAs and uterine polyps. The patient conceived two months after stopping hormonal therapy and proceeded to a pregnancy which resulted in a healthy live birth.
CONCLUSION: Although the etiology of the patient's molar pregnancy is still unknown, this report demonstrates the need to utilize hysteroscopy as a primary and early mode of treatment if IUAs are found in patients along with providing adjuvant treatment while utilizing clinical judgement in order to prevent IUAs recurrence. The patient conceived four months after the hysteroscopy resulting in a healthy live birth. © Individual authors.

Entities:  

Keywords:  hysteroscopy; intrauterine adhesions; molar pregnancy

Year:  2020        PMID: 34007656      PMCID: PMC8127118          DOI: 10.24926/iip.v11i4.3445

Source DB:  PubMed          Journal:  Innov Pharm        ISSN: 2155-0417


  17 in total

Review 1.  Clinical practice. Molar pregnancy.

Authors:  Ross S Berkowitz; Donald P Goldstein
Journal:  N Engl J Med       Date:  2009-04-16       Impact factor: 91.245

2.  Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction.

Authors: 
Journal:  Obstet Gynecol       Date:  2013-07       Impact factor: 7.661

Review 3.  Systematic review and meta-analysis of intrauterine adhesions after miscarriage: prevalence, risk factors and long-term reproductive outcome.

Authors:  Angelo B Hooker; Marike Lemmers; Andreas L Thurkow; Martijn W Heymans; Brent C Opmeer; Hans A M Brölmann; Ben W Mol; Judith A F Huirne
Journal:  Hum Reprod Update       Date:  2013-09-29       Impact factor: 15.610

4.  AAGL Practice Report: Practice Guidelines on Intrauterine Adhesions Developed in Collaboration With the European Society of Gynaecological Endoscopy (ESGE).

Authors: 
Journal:  J Minim Invasive Gynecol       Date:  2017-05-01       Impact factor: 4.137

5.  Committee Opinion No. 698: Hormone Therapy in Primary Ovarian Insufficiency.

Authors: 
Journal:  Obstet Gynecol       Date:  2017-05       Impact factor: 7.661

Review 6.  Current advances in the management of gestational trophoblastic disease.

Authors:  Ross S Berkowitz; Donald Peter Goldstein
Journal:  Gynecol Oncol       Date:  2012-07-27       Impact factor: 5.482

7.  The influence of the location and extent of intrauterine adhesions on recurrence after hysteroscopic adhesiolysis.

Authors:  J-H Yang; C-D Chen; S-U Chen; Y-S Yang; M-J Chen
Journal:  BJOG       Date:  2015-03-06       Impact factor: 6.531

Review 8.  A comprehensive review of Asherman's syndrome: causes, symptoms and treatment options.

Authors:  Christina A Salazar; Keith Isaacson; Stephanie Morris
Journal:  Curr Opin Obstet Gynecol       Date:  2017-08       Impact factor: 1.927

Review 9.  Diagnosis and treatment of gestational trophoblastic disease: ACOG Practice Bulletin No. 53.

Authors:  John T Soper; David G Mutch; Julian C Schink
Journal:  Gynecol Oncol       Date:  2004-06       Impact factor: 5.482

Review 10.  Asherman's syndrome: current perspectives on diagnosis and management.

Authors:  Eva Dreisler; Jens Joergen Kjer
Journal:  Int J Womens Health       Date:  2019-03-20
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