Hydatidiform Mole · Vaginal bleeding - The most common symptom of a complete mole is vaginal bleeding. · Hyperemesis - Patients may also complain of severe ...HydatidiformMoleINTRODUCTION　Background:Gestationaltrophoblasticdiseaseincludesseveraldiseaseprocessesthatoriginateintheplacenta.Thisincludescompleteandpartialmoles,placentalsitetrophoblastictumors,choriocarcinomasandinvasivemoles.Almostallwomenwithmalignantgestationaltrophoblasticdiseasecanbecuredwithpreservationofreproductivefunction.Thefollowingdiscussionwillbelimitedtohydatidiformmoles,completeandpartial.　Pathophysiology:Acompletemolecontainsnofetaltissue.90%are46XXand10%are46XY.Allchromosomesareofpaternalorigin.Anenucleateeggisfertilizedbyahaploidsperm,whichthenduplicatesitschromosomes,ortheeggisfertilizedby2sperm.Inacompletemolethechorionicvillihavegrapelike(hydatidiform)swelling,andthereistrophoblastichyperplasia.Withapartialmole,fetaltissueisoftenpresent.Thechromosomalcomplementis69XXXor69XXY.Thisresultsfromfertilizationofahaploidovumandduplicationofthepaternalhaploidchromosomes,orfromdispermy.Asinacompletemole,thereishyperplastictrophoblastictissueandswellingofthechorionicvilli.Frequency:　IntheUS:Inwesterncountries,1:1000-1:1500pregnanciesareaffected.Itisanincidentalfindinginapproximately1in600therapeuticabortions.Internationally:InAsiancountriestherateisasmuchas15timeshigherthanintheUS.Japanhasareportedrateof2per1000pregnancies.IntheFarEast,somesourcesestimatetherateashighas1:120pregnancies.Mortality/Morbidity:Ofpatientswithhydatidiformmole,20%willdevelopatrophoblasticmalignancy.Afteracompletemole,uterineinvasionoccursin15%ofpatients,andmetastasisoccursin4%ofpatients.Nocasesofchoriocarcinomahavebeenreportedafterapartialmole,although4%ofpatientswithpartialmolesdeveloppersistentnonmetastatictrophoblasticdiseaserequiringchemotherapy.Race:Thereisnoracial/ethnicpredilectionformolarpregnancy.However,asdiscussedinthesectiononfrequency,Asiancountriesshowarate15timeshigherthantheUS.AsianwomenlivingintheUSdono