THE SOURCE OF CIRCULATING PROGESTERONE AND 17α-HYDROXYPROGESTERONE IN HYDATIDIFORM MOLE

1972 ◽  
Vol 71 (4) ◽  
pp. 773-780 ◽  
Author(s):  
Eng Soon Teoh ◽  
N. P. Das ◽  
M. Yusoff Dawood ◽  
S. S. Ratnam
Keyword(s):  
Hydatidiform Mole ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Cyst Fluid ◽  
Secondary Source ◽  
The Third ◽  
Low Concentrations ◽  
Principal Source ◽  
Vesicle Fluid ◽  
Large Peak

ABSTRACT The source of the large amounts of circulating progesterone and the smaller quantities of 17α-hydroxyprogesterone in Hydatidiform Mole was studied by measuring progesterone, 17α-hydroxyprogesterone and 20α-hydroxyprogesterone in petroleum ether extracts of mole vesicle fluid and theca lutein cyst fluid following chromatography. The progesterone concentration in 10 samples of mole vesicle fluid ranged from 261–1493 ng/ml (mean 724 ng/ml) and was 8.6 times higher than the concentration in the serum. The chromatogram of the theca lutein cyst fluid showed a large peak of progesterone followed by two large secondary peaks of 20α-hydroxyprogesterone and 17α-hydroxyprogesterone. In 3 patients with benign Hydatidiform Mole, progesterone and human chorionic gonadotrophin rapidly decreased during the first 48 hours following evacuation of the mole. Thereafter, progesterone disappeared from the serum before HCG in one case, together with HCG in the second, and remained at low concentrations for 3 months in the third patient despite negative (below 0.6 IU/ml) HCG assays. The studies show that the mole trophoblast is the principal source of progesterone and the ovaries are a secondary source. Theca lutein cysts are the principal source of 17α-hydroxyprogesterone.

Normalisation of human chorionic gonadotrophin (hCG) levels in a patient with partial molar pregnancy with a uterine mass without chemotherapy: impact of using herbal remedies

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Norzila Ismail ◽  
Aida Maziha Zainudin ◽  
Gan Siew Hua
Keyword(s):  
Hydatidiform Mole ◽  
Abdominal Ultrasound ◽  
Massive Bleeding ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Herbal Remedies ◽  
Lung Field ◽  
Molar Pregnancy ◽  
Brucea Javanica

Abstract Objectives Level of βhCG and the presence of any uterine mass of hydatidiform mole need a careful review or monitoring in order to prevent metastasis, provide an early treatment and avoid unnecessary chemotherapy. Case presentation A 36-year old fifth gravida patient who had a missed abortion was diagnosed as having a molar pregnancy with beta human chorionic gonadotrophin (βhCG) level of 509,921 IU/L. Her lung field was clear and she underwent suction and curettage (S & C) procedure. However, after six weeks, AA presented to the emergency department with a massive bleeding, although her βhCG level had decreased to 65,770 IU/L. A trans-abdominal ultrasound indicated the presence of an intra-uterine mass (3.0 × 4.4 cm). Nevertheless, her βhCG continued to show a declining trend (8,426 IU/L). AA was advised to undergo a chemotherapy but she refused, citing preference for alternative medicine like herbs instead. She opted for an “at own risk” (AOR) discharge with scheduled follow up. Subsequently, her condition improved with her βhCG showing a downward trend. Surprisingly, at six months post S & C, her βhCG ameliorated to 0 IU/L with no mass detected by ultrasound. Conclusions Brucea javanica fruits, Pereskia bleo and Annona muricata leaves can potentially be useful alternatives to chemotherapy and need further studies.

SERUM PROGESTERONE AND SERUM CHORIONIC GONADOTROPHIN IN HYDATIDIFORM MOLE AND CHORIOCARCINOMA

1972 ◽  
Vol 70 (4) ◽  
pp. 791-800 ◽  
Author(s):  
Eng Soon Teoh ◽  
N. P. Das ◽  
M. Yusoff Dawood ◽  
S. S. Ratnam
Keyword(s):  
Petroleum Ether Extract ◽  
Hydatidiform Mole ◽  
Haemagglutination Inhibition ◽  
Normal Pregnancy ◽  
Chorionic Gonadotrophin ◽  
Serum Progesterone ◽  
Small Peak ◽  
Low Concentrations ◽  
Competitive Protein Binding Assay ◽  
The Mean

ABSTRACT Progesterone and human chorionic gonadotrophin (HCG) were measured in the sera of 25 patients with hydatidiform mole, 10 patients with choriocarcinoma and 200 normal pregnancies by a competitive protein-binding assay and a haemagglutination-inhibition assay respectively. Elution of the petroleum ether extract of mole serum on Sephadex LH-20 showed that the main fraction (92.8%) was progesterone, followed by a small peak of 20 α-hydroxyprogesterone. In 21 intact hydatidiform moles, the mean serum progesterone of 106.0 ng/ml (range 17.8–263 ng/ml) was higher than for normal pregnancy. Serum HCG (mean 833 IU/ml) was similarly elevated. Low concentrations of progesterone (0–17.3 ng/ml) and HCG (15–160 IU/ml) were present in 4 patients who had aborted. The mean serum progesterone was not further elevated in patients with theca lutein cysts of the ovary. There was no correlation between the serum progesterone and the uterine size, serum HCG or malignant sequelae. In 10 cases of choriocarcinoma, the serum progesterone ranged from 1.3–61 ng/ml (mean 16.9 ng/ml), the serum HCG from 0–960 IU/ml (mean 158 IU/ml) but there was no correlation between the two values. The evidence suggests a hyperactive steroidogenesis in hydatidiform mole and poor steroidogenesis in choriocarcinoma. An HCG secretion occurs in both cases.

scholarly journals An Incidental Ultrasonographic Diagnosis of Partial Hydatidiform Mole in a Old Primigravida: A Case Report

2020 ◽  
Vol 58 (222) ◽  
Author(s):  
Sudeep Thapa ◽  
Ramesh Rana ◽  
Sheela Kumari
Keyword(s):  
Hydatidiform Mole ◽  
Cardiac Activity ◽  
First Trimester ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Antenatal Visit ◽  
Partial Hydatidiform Mole ◽  
Trophoblastic Cells ◽  
Asian Populations ◽  
Beta Human Chorionic Gonadotrophin

Hydatidiform mole is an abnormal pregnancy common in Asian populations compared to western countries; however, a partial hydatidiform mole is relatively uncommon and very challenging to diagnose on ultrasound. We reported a 24 years old female visited our clinic whose first antenatal visit was regular with normal viable fetus on ultrasonographic scan. However, an uneventful scan at 12 weeks period of gestation revealed a large irregular gestational sac with the disproportionately small embryo corresponding to 6+6 weeks with no cardiac activity. Additionally, there was markedly thickened placenta measuring 30mm in thickness without cystic spaces within the placenta. Further, her beta-human chorionic gonadotrophin level was very high and suction evacuation sample showed hydropic chorionic villi lined by trophoblastic cells with cistern formation and scalloped border. In conclusion, partial hydatidiform mole is an uncommon molar pregnancy rarely diagnose on ultrasonography. Late first-trimester scan and excessively high beta-human chorionic gonadotrophin levels confirm the diagnosis.

TREATMENT OF EUNUCHOIDAL MEN WITH HUMAN CHORIONIC GONADOTROPHIN AND FOLLICLE-STIMULATING HORMONE

1968 ◽  
Vol 42 (3) ◽  
pp. 441-451 ◽  
Author(s):  
A. C. CROOKE ◽  
A. G. DAVIES ◽  
R. MORRIS
Keyword(s):  
Follicle Stimulating Hormone ◽  
Combined Treatment ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Human Pituitary ◽  
Somatic Development ◽  
Low Concentrations ◽  
Urinary Levels ◽  
Total Body ◽  
Stimulating Hormone

SUMMARY Large doses of human chorionic gonadotrophin and human pituitary follicle-stimulating hormone were given singly and in combination to six eunuchoidal men. None had an increased excretion of urinary gonadotrophin before treatment. Histological examination of the testicles showed very immature germinal epithelium in five of the patients before treatment. Spermatozoa were found histologically in three patients, only after combined treatment with both gonadotrophins. Low concentrations of spermatozoa appeared in semen from two of these patients. One patient was found to have histological evidence of spermatogenesis before treatment but was unable to produce semen. Treatment with chorionic gonadotrophin alone enabled him to produce semen containing up to 15,000,000 spermatozoa per ml. Significant increases were found in the urinary levels of a variety of steroids and in total body potassium after treatment with chorionic gonadotrophin and a variable amount of somatic development took place.

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