Background and Objectives: Complete hydatidiform MOLE is the most common form of trophoblastic disease, the incidence of which greatly differs geographically and is fairly high in our country too. The aim of this study was to determine the frequency of molar pregnancy in our patients and assess the ultrasonic findings of the disease.Materials and Methods: From July 1985 to February 1997, 11,370 women with normal or pathologic pregnancies underwent ultrasonic examination in Obstetrics and Gynecologic (Al-Zahra) Hospital of Faculty of Medicine, Tabriz University of Medical Sciences and Azarbaijan Radiologic and Sonologic Clinics (Private). Results: Among 11,370 patients, 10,414 women had normal pregnancies and from 935 remainders with different associated pathologic conditions, 100 patients had hydatidiform MOLE (98 complete and 2 partial MOLE). In this study, the incidence of hydatidiform MOLE was 8.7 in 1000 pregnancies which approximate to Saleh and co-worker's study (1964-65), but has considerable differences in comparison to Javey and Sajjady’s findings (1970-75) and the Western and the Far East countries statistics.Conclusion: Occurrence of hydatiform MOLE is not a common finding, however its prevalence is fairly high in our country in comparison to other studies reported earlier.

Introduction: This study was performed to establish a complementary method to the diagnosis of complete hydatidiform MOLE and its differentiation from the other cases of gestational trophoblastic disease by measuring the total (ALP) and placental alkaline phosphatase (PLAP) specific activity. Materials and Methods: Serum and tissue extracts from 13 patients, 13 normal non-pregnant and 30 pregnant females were compared for these enzymes activities. Paranitrophenyl phosphate was used as substrate. Placental alkaline phosphatase was simply distingushed from its isoenzymes by its heat stability (65°c for 15min).Results: According to our findings from serum and tissue extract examination the activity of total alkaline phosphatase and placental alkaline phosphatase activities were reduced in hydatidiform MOLE patients in comparsion with pregnant females (P<0.05) but there was no significant difference in non - pregnant subject. Conclusion: These results show a severe hypophosphatasia in serum and tissue extracts of the patients. The reduction in activity of enzymes may be caused by low synthesis of enzyme by trophoblast cells or some post transcriptional changes that causse the reduction of enzyme activity. Since the ALP is probably important in active transport of suger and phosphate across the trophoblast cell membreanes, so the hydropic villi of hydatidiform MOLE placenta may due to reduction of enzyme activity in placental villi. Our results suggest that measurment of ALP and PLAP activity in serum and tissue extract can be a complementary method in diagnosis of hydatidiform MOLE.

A 23-year-old Gravida 3 Para 1+1 at 26 weeks and four days of amenorrhea presented at our obstetrics and gynecology clinic for assessment following a coincidental scan that revealed a single live intrauterine fetus in cephalic presentation, longitudinal lie with normal cardiac activity, heart rate of 150 beats per minute, normal gross anatomy and estimated fetal weight of 992 grams. . .

Background: Invasive MOLE is responsible for most cases of localized gestational trophoblastic neoplasia. Gestational trophoblastic disease describes a number of gynecologic tumors that originate in trophoblastic layer including hydatidiform MOLE (complete or partial), invasive MOLE, choriocarcinoma, placental site trophoblastic tumor and epitheloid trophoblastic tumor. Invasive MOLE may arise from any pregnancy event although in most cases is diagnosed after molar pregnancy. Overall cure rate in low risk patients is nearly 100% and in high-risk patient 90%. In rare cases, molar tissue traverses thickness of myometrium and leads to perforation and acute abdomen and invasive MOLE infrequently metastasis. The best treatment option is chemotherapy (according to stage and score with single or multiple agent) and in patients that fertility is not the matter, hysterectomy can be done.Case Presentation: A 41 years old G3P2ab1 woman referred to Firouzgar hospital 2 months after curettage of molar pregnancy with vaginal bleeding and acute abdomen.In workup, HCG 224000mIU/ml and evidence of metastasis was detected.Chemotherapy due to stage 3 and score 9 and surgery due to acute abdomen was done. This case was reported for its rarity.Discussion: This case reported about ovarian metastasis and uterine rupture with acute abdomen and involvement of omentum in metastatic invasive MOLE. Lack of surveillance led to extensive morbidity. Management of this patient was successful.In follow up, she was free of disease without sequel of any kind for five years now.

The "MOLE" is a black spot which is appeared in a figure and is a Gnostic term which means "point of virtuality" and "points of unity" .The term "MOLE" is used by many writers and poets in their literary works and considerably cared about using that. The writer, himself spent sometime in India and closely as withnessed some rituals of those who were achieving ti the "MOLE" stage in Hindu"s temples. He has tried to express some new point of views about "MOLE", regarding to poems of Hafez that can help readers in realizing the verses.