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Gestational trophoblastic disease

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https://www.readbyqxmd.com/read/28725005/endothelial-dysfunction-in-severe-preeclampsia-is-mediated-by-soluble-factors-rather-than-extracellular-vesicles
#1
Michelle O'Brien, Dora Baczyk, John C Kingdom
In severe early-onset preeclampsia (sPE) the placenta releases soluble angiogenesis-regulating proteins, trophoblast-derived fragments, and extracellular vesicles (EVs). Their relative importance in disease pathogenesis is not presently understood. We explanted placental villi from healthy and sPE women then separated the media into: total-conditioned, EV-depleted and EV-enriched media. Three fractions were compared for; angiogenic protein secretion by ELISA, angiogenic and inflammation gene mRNA expression and leukocyte adhesion assay...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28717722/gestational-trophoblastic-neoplasia-treatment-at-the-butaro-cancer-center-of-excellence-in-rwanda
#2
Ignace Nzayisenga, Roanne Segal, Natalie Pritchett, Mary J Xu, Paul H Park, Edgie V Mpanumusingo, Denis G Umuhizi, Donald P Goldstein, Ross S Berkowitz, Vedaste Hategekimana, Clemence Muhayimana, Fidel Rubagumya, Temidayo Fadelu, Neo Tapela, Tharcisse Mpunga, Rahel G Ghebre
PURPOSE: Gestational trophoblastic neoplasia (GTN) is a highly treatable disease, most often affecting young women of childbearing age. This study reviewed patients managed for GTN at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda to determine initial program outcomes. PATIENTS AND METHODS: A retrospective medical record review was performed for 35 patients with GTN assessed or treated between May 1, 2012, and November 30, 2014. Stage, risk score, and low or high GTN risk category were based on International Federation of Gynecology and Obstetrics staging and the WHO scoring system and determined by beta human chorionic gonadotropin level, chest x-ray, and ultrasound per protocol guidelines for resource-limited settings...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716993/low-soluble-fms-like-tyrosine-kinase-1-endoglin-and-endothelin-1-levels-in-women-with-confirmed-or-suspected-preeclampsia-using-proton-pump-inhibitors
#3
Langeza Saleh, Raaho Samantar, Ingrid M Garrelds, Anton H van den Meiracker, Willy Visser, A H Jan Danser
Patients with preeclampsia display elevated placenta-derived sFlt-1 (soluble Fms-like tyrosine kinase-1) and endoglin levels and decreased placental growth factor levels. Proton pump inhibitors (PPIs) decrease trophoblast sFlt-1 and endoglin secretion in vitro. PPIs are used during pregnancy to combat reflux disease. Here, we investigated whether PPIs affect sFlt-1 in women with confirmed/suspected preeclampsia, making use of a prospective cohort study involving 430 women. Of these women, 40 took PPIs (6 esomeprazole, 32 omeprazole, and 2 pantoprazole) for 8 to 45 (median 29) days before sFlt-1 measurement...
July 17, 2017: Hypertension
https://www.readbyqxmd.com/read/28713902/establishment-and-characterization-of-cell-lines-derived-from-complete-hydatidiform-mole
#4
Eiko Yamamoto, Kaoru Niimi, Tohru Kiyono, Toshimichi Yamamoto, Kimihiro Nishino, Kenichi Nakamura, Tomomi Kotani, Hiroaki Kajiyama, Kiyosumi Shibata, Fumitaka Kikkawa
Gestational trophoblastic diseases (GTDs) are a group of diseases characterized by abnormal cellular proliferation of atypical trophoblasts. A hydatidiform mole is an abnormal pregnancy caused by genetic fertilization disorders, and it can be classified as a complete hydatidiform mole (CHM) or a partial hydatidiform mole. The aim of this study was to establish cell lines from CHMs and to characterize the cells for future studies concerning GTD. HMol1-2C, HMol1-3B, HMol1-8 and HMol3-1B were established from primary cultures of CHM explants following the introduction of different combinations of genes including human telomerase reverse transcriptase (hTERT), a mutant form of CDK (CDK4R24C), cyclin D1, p53C234, MYC and HRAS...
July 14, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28692637/comparison-of-2-human-chorionic-gonadotropin-immunoassays-commercially-available-for-monitoring-patients-with-gestational-trophoblastic-disease
#5
Juliana Maria Quinalha de Souza, Antonio Braga, Rafael Sanches Dos Santos, Marcos Montanha Ramos, Rafael Cortés-Charry, Izildinha Maestá
OBJECTIVE: The aim of this study was to compare serum human chorionic gonadotropin (hCG) levels in patients with gestational trophoblastic disease (GTD) using 2 commercially available hCG immunoassays. METHODS: Serum samples were obtained from patients with GTD attending the Botucatu Medical School Trophoblastic Diseases Center of São Paulo State University (UNESP), from November 2014 to October 2015. Serum hCG levels were measured with both Architect i2000SR and Immulite 2000 XPi chemiluminescence assays...
July 7, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28651476/molecular-mechanisms-of-intrauterine-growth-restriction
#6
Rao Gurugubelli Krishna, B Vishnu Bhat
Intrauterine growth restriction (IUGR) is a pregnancy specific disease characterized by decreased growth rate of fetus than the normal growth potential at particular gestational age. In the current scenario it is a leading cause of fetal and neonatal morbidity and mortality. In the last decade exhilarating experimental studies from several laboratories have provided fascinating proof for comprehension of molecular basis of IUGR. Atypical expression of enzymes governed by TGFβ causes the placental apoptosis and altered expression of TGFβ due to hyper alimentation causes impairment of lung function...
July 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28614227/case-report-of-pulmonary-epithelial-trophoblastic-tumor-in-a-young-female-patient
#7
Lijun Jiang, Hongfei Xu, Yuan Lu, Weidong Li, Chengfei Zheng
INTRODUCTION: An epithelial trophoblastic tumor (ETT) is a kind of rare trophoblastic tumor that may have the correlation with a prior gestational event. Especially, the one that appears in the lung is extremely rare. CASE SUMMARY: Here, we present a 24-year-old female patient with the chief complain of vaginal bleeding for more than 1 month, who was found to have a large mass (7.5 × 4.5 cm) in the right lower lobe, and it was finally confirmed as lung ETT by postoperative pathology after a successful radical resection of the pulmonary lobe...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28607326/morphological-features-and-immunohistochemical-expression-of-p57kip2-in-early-molar-pregnancies-and-their-relations-to-the-progression-to-persistent-trophoblastic-disease
#8
Marwa Khashaba, Mohammad Arafa, Eman Elsalkh, Reda Hemida, Wagiha Kandil
Background: Although the morphological features characteristic of products of conception specimens including molar pregnancies are well described, substantial histopathological similarities are observed between the different entities, especially in cases of early pregnancies. Furthermore, there are no current solid criteria that could predict cases with progression to persistent gestational trophoblastic disease. In this study, we aimed to determine the most specific histopathological and immunohistochemical features required for accurate diagnosis that can reliably predict the clinical behavior...
June 12, 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/28591340/uterine-artery-doppler-flow-velocimetry-parameters-for-predicting-gestational-trophoblastic-neoplasia-after-complete-hydatidiform-mole-a-prospective-cohort-study
#9
Flavia Tarabini Castellani Asmar, Antonio Rodrigues Braga-Neto, Jorge de Rezende-Filho, Juliana Marques Simões Villas-Boas, Rafael Cortés Charry, Izildinha Maesta
OBJECTIVES: Doppler ultrasonography can be used to assess neoangiogenesis, a characteristic feature of postmolar gestational trophoblastic neoplasia. However, there is limited information on whether uterine artery Doppler flow velocimetry parameters can predict gestational trophoblastic neoplasia following a complete hydatidiform mole. The purpose of this study was as follows: 1) to compare uterine blood flow before and after complete mole evacuation between women who developed postmolar gestational trophoblastic neoplasia and those who achieved spontaneous remission, 2) to assess the usefulness of uterine Doppler parameters as predictors of postmolar gestational trophoblastic neoplasia and to determine the best parameters and cutoff values for predicting postmolar gestational trophoblastic neoplasia...
May 2017: Clinics
https://www.readbyqxmd.com/read/28590345/two-cases-of-epithelioid-trophoblastic-tumors-in-postmenopausal-women
#10
Adriano Rodríguez-Trujillo, María José Martínez-Serrano, Adela Saco, Aureli Torné
OBJECTIVE: Epithelioid trophoblastic tumor is a rare gestational trophoblastic neoplasm usually presenting in women of reproductive age, with a history of a prior gestational event. Its presentation in postmenopausal women is extremely rare. Immunohistochemical staining is a helpful aid to distinguish epithelioid trophoblastic tumor from other gestational trophoblastic neoplasms. Correct diagnosis is crucial for clinical management that can vary according to the type of gestational trophoblastic neoplasm...
June 5, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28571514/obstetric-ultrasound-aids-prompt-referral-of-gestational-trophoblastic-disease-in-marginalized-populations-on-the-thailand-myanmar-border
#11
Kathryn McGregor, Aung Myat Min, Noaeni Karunkonkowit, Suporn Keereechareon, Mary Ellen Tyrosvoutis, Nay Win Tun, Marcus J Rijken, Gabie Hoogenboom, Machteld Boel, Kesinee Chotivanich, François Nosten, Rose McGready
BACKGROUND: The use of obstetric ultrasound in the diagnosis of gestational trophoblastic disease (GTD) in high-income settings is well established, leading to prompt management and high survival rates. Evidence from low-income settings suggests ultrasound is essential in identifying complicated pregnancies, but with limited studies reviewing specific conditions including GTD. OBJECTIVE: The aim of this study is to review the role of ultrasound in diagnosis and management of GTD in a marginalized population on the Thailand-Myanmar border...
2017: Global Health Action
https://www.readbyqxmd.com/read/28567058/implementation-and-monitoring-of-a-gestational-trophoblastic-disease-management-program-in-a-tertiary-hospital-in-morocco-opportunities-and-challenges
#12
Imane Khachani, Mohamed Hassan Alami, Rachid Bezad
Objective. Gestational Trophoblastic Disease (GTD) management requires clear guidelines for diagnosis, treatment, and follow-up. Unequal management skills among practitioners, inadequate treatment, irregular surveillance, and drop-out are common in resource-limited settings and can lead to life-threatening complications and morbidities. To address these challenges, we implemented a GTD Management Program at the National Center for Reproductive Health in Rabat, Morocco. Methods and Program Description. In-depth review of management protocols was carried out, and concise guidelines were developed, with targeted training for physicians...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28548328/epithelioid-trophoblastic-tumor-of-the-uterus-a-case-report-with-radiologic-pathologic-correlation
#13
Ayumi Ohya, Kayoko Higuchi, Hisashi Shimojo, Yasunari Fujinaga, Masumi Kadoya, Shigeki Shiohara
Herein, we report a rare case of an epithelioid trophoblastic tumor of the uterus with radiologic-pathologic correlation in a 56-year-old postmenopausal woman. On T2-weighted magnetic resonance (MR) imaging, the tumor appeared as a hypointense irregular mass compared with the surrounding myometrium of the uterine corpus and encircled the cavity of the lower uterine segment. On dynamic contrast-enhanced MR images, the tumor appeared as a hypovascular mass and an inhomogeneously hyperintense mass in the delayed phase...
May 26, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28546716/complete-molar-pregnancy-in-postmenopausal-woman
#14
Ahmed Samy El-Agwany, Helmy Abdelsattar Rady, Hassan Mansour Hegab
Gestational trophoblastic disease spectrum ranges from benign hydatidiform mole to trophoblastic malignancy (placental site trophoblastic tumor and choriocarcinoma). Benign gestational trophoblastic disease occurs in women of reproductive age and is extremely rare in postmenopausal women. We describe a case of complete vesicular mole in a 55-year-old postmenopausal woman complaining of postmenopausal bleeding. To our knowledge, our case represents one of the rare descriptions in the world literature of a benign complete hydatidiform mole in a postmenopausal woman...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28536048/cell-free-dna-inflammation-and-the-initiation-of%C3%A2-spontaneous-term-labor
#15
Christina A Herrera, Jay Stoerker, John Carlquist, Gregory J Stoddard, Marc Jackson, Sean Esplin, Nancy C Rose
BACKGROUND: Hypomethylated cell-free DNA from senescent placental trophoblasts may be involved in the activation of the inflammatory cascade to initiate labor. OBJECTIVE: To determine the changes in cell-free DNA concentrations, the methylation ratio, and inflammatory markers between women in labor at term vs women without labor. STUDY DESIGN: In this prospective cohort study, eligible participants carried a nonanomalous singleton fetus. Women with major medical comorbidity, preterm labor, progesterone use, aneuploidy, infectious disease, vaginal bleeding, abdominal trauma, or invasive procedures during the pregnancy were excluded...
May 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28515588/placental-mesenchymal-dysplasia-what-every-radiologist-needs-to-know
#16
Disha Mittal, Rama Anand, Neha Sisodia, Smita Singh, Ratna Biswas
Placental mesenchymal dysplasia (PMD) is an uncommon vascular anomaly of the placenta characterized by placentomegaly with multicystic placental lesion on ultrasonography and mesenchymal stem villous hyperplasia on histopathology. Placental mesenchymal dysplasia should be considered in the differential diagnosis of cases of multicystic placental lesion such as molar pregnancy, chorioangioma, subchorionic hematoma, and spontaneous abortion with hydropic placental changes. However, lack of high-velocity signals inside the lesion and a normal karyotype favor a diagnosis of PMD...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28497716/polyglucosan-bodies-in-placental-extravillious-trophoblast-for-the-diagnosis-of-fatal-perinatal-neuromuscular-type-glycogen-storage-disease-type-iv
#17
Weiming Yu, Marie-Anne Brundler, James R Wright
The fatal infantile neuromuscular type is the most severe form of glycogen storage disease type IV. We report a case of a 22-day-old female neonate born at 34 weeks gestation with polyhyramnios, fetal hydrops, and severe hypotonia. Placental examination revealed numerous periodic acid schiff (PAS)-positive diastase-resistant polyglucosan bodies in the cytoplasm of extravillous trophoblast predominantly in the placental basal plate. Muscle biopsy and autopsy findings supported a diagnosis of neuromuscular-type glycogen storage disease IV with extensive involvement of skeletal muscle, heart, and liver...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28491173/radiographically-occult-pulmonary-metastases-from-gestational-trophoblastic-neoplasia
#18
Tina Hong, Edward Hills, Maria Del Pilar Aguinaga
Gestational trophoblastic neoplasia (GTN) is a spectrum of diseases including partial and complete hydatidiform moles, placental site trophoblastic tumor, and choriocarcinoma. One of the most important considerations is recognition of the possibility of GTN after molar pregnancy or even normal pregnancy. It is common practice to use chest x-ray for the detection of pulmonary metastasis. Computed tomography imaging of the lungs is ordered if lung lesions are noted on chest x-rays. However, understanding the limitations of chest x-rays is important for detecting smaller pulmonary lesions...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489216/the-role-of-surgery-in-the-management-of-women-with-gestational-trophoblastic-disease
#19
Lana DE Lourdes Aguiar Lima, Lílian Padron, Raphael Câmara, Sue Yazaki Sun, Jorge Rezende, Antônio Braga
The Gestational Trophoblastic Disease includes an interrelated group of diseases originating from placental tissue, with distinct behaviors concerning local invasion and metastasis. The high sensitivity of the serial dosages of human chorionic gonadotrophin, combined with advances in chemotherapy treatment, have made gestational trophoblastic neoplasia curable, most often through chemotherapy. However, surgery remains of major importance in the management of patients with gestational trophoblastic disease, improving their prognosis...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28483162/quo-vadis-trophoblast-exploring-the-new-ways-of-an-old-cell-lineage
#20
Sascha Drewlo, D Randall Armant
Trophoblast cells are the first embryonic lineage to differentiate during human development, and are needed to sustain fetal life through their role in constructing a placenta. As the fetus grows, the trophoblast rapidly expands and further differentiates to produce an extravillous subtype that invades the maternal tissues. Some of the extravillous trophoblast cells find their way into the reproductive tract, and can be safely captured by noninvasive collection from the endocervical canal, similarly to a Pap smear...
April 26, 2017: Placenta
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