Altri fattori di rischio verosimilmente includono le diete a basso contenuto di proteine , vitamina B12 , acido folico   e carotene. Le vescicole derivano dalla distensione dei villi coriali ad opera del fluido. In rari casi, una mola idatiforme coesiste in utero con un feto normale e vitale. Questi casi sono dovuti al fenomeno dei gemelli.
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Signs and symptoms[ edit ] Vesicular mole Molar pregnancies usually present with painless vaginal bleeding in the fourth to fifth months of pregnancy. There may also be more vomiting than would be expected hyperemesis. Sometimes there is an increase in blood pressure along with protein in the urine. Blood tests will show very high levels of human chorionic gonadotropin hCG.
Potential risk factors may include defects in the egg, abnormalities within the uterus , or nutritional deficiencies. Women under 20 or over 40 years of age have a higher risk.
Other risk factors include diets low in protein , folic acid , and carotene. This leads to overgrowth of the syncytiotrophoblast whereas dual egg-patterned methylation leads to a devotion of resources to the embryo, with an underdeveloped syncytiotrophoblast.
This is considered to be the result of evolutionary competition , with male genes driving for high investment into the fetus versus female genes driving for resource restriction to maximise the number of children.
The vesicles arise by distention of the chorionic villi by fluid. When inspected under the microscope, hyperplasia of the trophoblastic tissue is noted. If left untreated, a hydatidiform mole will almost always end as a spontaneous abortion miscarriage. Based on morphology , hydatidiform moles can be divided into two types: in complete moles, all the chorionic villi are vesicular, and no sign of embryonic or fetal development is present. Uterus with complete hydatidiform mole In rare cases a hydatidiform mole co-exists in the uterus with a normal, viable fetus.
These cases are due to twinning. The uterus contains the products of two conceptions: one with an abnormal placenta and no viable fetus the mole , and one with a normal placenta and a viable fetus.
Under careful surveillance it is often possible for the woman to give birth to the normal child and to be cured of the mole. In both cases, the moles are diploid i. In all these cases, the mitochondrial genes are inherited from the mother, as usual.
Most partial moles are triploid three chromosome sets. The nucleus contains one maternal set of genes and two paternal sets. The mechanism is usually the reduplication of the paternal haploid set from a single sperm, but may also be the consequence of dispermic two sperm fertilization of the egg.
A small percentage of hydatidiform moles have biparental diploid genomes, as in normal living persons; they have two sets of chromosomes, one inherited from each biological parent.
Some of these moles occur in women who carry mutations in the gene NLRP7 , predisposing them towards molar pregnancy. These rare variants of hydatidiform mole may be complete or partial. Molar pregnancy in ultrasound Hydatidiform mole on CT, sagittal view Hydatidiform mole on CT, axial view The diagnosis is strongly suggested by ultrasound sonogram , but definitive diagnosis requires histopathological examination.
On ultrasound, the mole resembles a bunch of grapes "cluster of grapes" or "honeycombed uterus" or "snow-storm" . There is increased trophoblast proliferation and enlarging of the chorionic villi.
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