妇产科课件-妊娠滋养细胞疾病en课件.pptVIP

Gestational trophoblastic Disease GTD 妊娠滋养细胞疾病 妊娠滋养细胞疾病(gestational trophoblastic disease, GTD) Hydatidiform Mole [Definition] an abnormal pregnancy characterized grossly by multiple grapelike vesicles filling and distending the uterus , proliferation of syncytiotrophoblastic or cytotrophoblastic element, edema of the villous stroma. Hydatidiform Mole [Classification] 　　　　 complete hydatidiform mole, CHM (more common) 　　　　 partial　hydatidiform mole, PHM AII are benign disease. Epidemiology The incidence varies greatly between different parts of the world. The incidence from Europe and North America is significantly lower than Asia and South America. morbidity: 290/100,000 0.78/1000 pregnancy in our country High risk: 20 years of age, or 40 years old Lack of carotine and animal fat Etiology Race and region difference malnutrition: lack of folic acid, lack of carotine virus infection hydatidiform mole history endocrine dyscrasia：lack of estrogen defect of fertilized egg immunology factor: human leucocyte antigen(HLA) Etiology Cell chromosome mutation: complet mole: diploid, enucleate egg fertilization, 90% is 46XX,10% is 46XY incomplete mole: triploid, formed by the fertilization of a monoploid egg and two monoploid sperm, or by a monoploid egg(sperm) and a meiotic deficiency sperm(egg), most is 69XXY, and then is 69XXX or 69XYY. Pathology Macroscopy：grapelike vesicles Microscopy： ? trophocyte hyperplasia edema of villous stroma stromal vascular absent or rare Complete mole incomplete mole Embryotic or fetal tissue - + Villus stromal edema diffused localized Trophoblastic hyperplasia diffused localized Villus outline regular irregular Villus stromal blood vessel