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Two main risk factors increase the likelihood for the development of GTD: 1) The woman being under 20 years of age, or over 35 years of age, and 2) previous GTD. [8] [9] [10] Although molar pregnancies affect women of all ages, women under 16 and over 45 years of age have an increased risk of developing a molar pregnancy. [11]
A molar pregnancy, also known as a hydatidiform mole, is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus. It falls under the category of gestational trophoblastic diseases. [1] During a molar pregnancy, the uterus contains a growing mass characterized by swollen chorionic villi, resembling clusters of ...
Gestational choriocarcinoma can happen during and after any type of pregnancy event, though risk of the disease is higher in and after complete or partial molar pregnancies. [3] Risk of disease may also be higher in those experiencing pregnancy at younger or older ages that average, such as below 15 years old or above 45 years old. [4]
GTN often arises after molar pregnancies but can also occur after any gestation including miscarriages and term pregnancies. [6] Although risk factors may impact on the development of the tumor, most do not directly cause of disease. According to some studies, the risk of complete molar pregnancy is highest in women over age 35 and younger than 20.
“Gravidity” is an important component of a patient’s reproductive history, as it provides insight into the risk factors that the patient has for pregnancy outcomes, such as risk for gestational diabetes, pre-ecclampsia, spontaneous abortion, preterm birth, fetal growth restriction, and more. [5]
Theca lutein cysts are associated with gestational trophoblastic disease (molar pregnancy), choriocarcinomas, and multiple gestations. [4] [5] In some cases, these cysts may also be associated with diabetes mellitus and alloimmunisation to Rh-D. They have rarely been associated with chronic kidney disease and hyperthyroidism. [6]
Choriocarcinoma of the placenta during pregnancy is preceded by: hydatidiform mole (50% of cases) spontaneous abortion (20% of cases) ectopic pregnancy (2% of cases) normal term pregnancy (20–30% of cases) hyperemesis gravidarum; Rarely, choriocarcinoma occurs in primary locations other than the placenta; very rarely, it occurs in testicles.
Pregnancy loss is a broad term that is used for miscarriage, ectopic and molar pregnancies. [31] The term foetal death applies variably in different countries and contexts, sometimes incorporating weight, and gestational age from 16 weeks in Norway, 20 weeks in the US and Australia, 24 weeks in the UK to 26 weeks in Italy and Spain.
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