Hydatidiform mole resulting from sexual violence

Description of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital Pérola Byington, S？o Paulo, from July 1994 to August 2011.The cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection.The incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition.Gestational impairments are important factors to be investigated [1,2], since it affects children development [3-5]. The hydatidiform mole (HM) is a variant of gestational trophoblastic disease, a generic term that brings together different conditions of proliferation of trophoblastic epithelium, with abnormal functioning tissue producing human chorionic gonadotropin (hCG) [6]. The gestational trophoblastic disease includes forms of HM, invasive mole, gestacional choriocarcinoma and placental site trophoblastic tumor, according to anatomoclinical criteria [7].The choriocarcinoma is the most severe form of the disease with potential for invasion and metastasis, affecting every 20,000 pregnancies [8]. The etiology of HM is unknown. Studies associate it with nutritional deficiencies, environmental conditions, herbicides, parity, smoking, extremes of maternal age, intrauterine device, inbreeding, viral infections, oral h