TAILIEUCHUNG - Ebook Shaw’s textbook of gynaecology (16th edition): Part 2

(BQ) Part 2 book "Shaw’s textbook of gynaecology" presents the following contents: Gestational trophoblastic diseases, disorders of menstruation-Amenorrhoea, menorrhagia, genital prolapse, diseases of the vulva, diseases of the vagina, benign diseases of the uterus, endometriosis and adenomyosis, disorders of the ovary, acute and chronic pelvic pain,. and other content. | Chapter 22 Gestational Trophoblastic Diseases CHAPTER OUTLINE Hydatidiform Mole 311 Investigations 315 Incidence and Aetiology 311 Morbid Anatomy 311 Invasive Mole Persistent or Residual 313 Placental Site Trophoblastic Tumour 313 Aetiology 313 Classification 313 Symptoms and Signs 314 Differential Diagnosis 315 Complications 315 Treatment 316 Follow-Up 316 Persistent Trophoblastic Disease 318 Perforating Mole 318 Recurrent Molar Pregnancy 318 Coexisting Molar Pregnancy 319 Key Points 319 Self-Assessment 319 Gestational trophoblastic diseases GTDs comprise a variety of biologically interrelated conditions which form a clinical spectrum from a benign partial hydatidiform mole at the one end to the highly malignant choriocarcinoma at the other without any precise line of demarcation. This spectrum extends from a very early pregnancy H. mole to years after the pregnancy is over choriocarcinoma . Trophoblastic tumours may be categorized into three broad groups Table 1. Benign hydatidiform mole It may be a complete or a partial mole. The tumour sometimes invades the wall of the uterus and the surrounding structures when it is called an invasive mole. 2. Persistent trophoblastic disease PTD also known as residual trophoblastic disease RTD includes the invasive mole. 3. Choriocarcinoma This is truly a malignant tumour. It could be a nonmetastatic NMTD or a metastatic MTD trophoblastic disease. Metastatic tumour may be of low or high risk. Hydatidiform Mole Incidence and Aetiology The incidence of the disease is higher in the eastern countries than in the West. Its geographical distribution is as follows UK and USA 1 2000 to 1 3000 India and the MiddleEast 1 160 to 1 500 China 1 150 Philippines 1 173 Indonesia and Taiwan 1 82 pregnancies. Likewise the malignant potential of this disease is higher in Southeast Asia where it is as high as 10-15 compared to 2-4 in the western countries. Some immigrants from Southeast Asia to a developed country lose the potential to .

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• Shaw’s textbook of gynaecology
• Gestational trophoblastic diseases
• Genital prolapse
• Diseases of the vulva
• Diseases of the vagina
• Endometriosis and adenomyosis
• Disorders of the ovary