Bleeding in Early Pregnancy Flashcards
What disorders are included in gestational trophoblastic disease (GTD)?
- Complete molar pregnancy
- Partial molar pregnancy
- Invasive mole
- Choriocarcinoma
- Placental site trophoblastic tumor (PSTT).
What is gestational trophoblastic neoplasia (GTN)?
A condition characterized by a persistent elevation of βhCG after GTD.
How are molar pregnancies classified?
Based on genetic and histopathological features.
- Complete moles (CM)
- Partial moles (PM)
What is the genetic origin of complete moles?
Diploid and androgenic, with no fetal tissue evidence.
What is the most common cause of complete moles?
Duplication of a single sperm after fertilization of an empty ovum.
What is the genetic origin of partial moles?
Triploid, with two paternal haploid and one maternal haploid gene sets.
List some clinical presentations of GTD.
- Irregular vaginal bleeding
- Hyperemesis
- Excessive uterine enlargement
- Early failed pregnancy.
What systemic symptoms can GTD cause?
- Hyperthyroidism
- Early pre-eclampsia
- Abdominal distension due to theca lutein cysts.
How is GTD diagnosed using ultrasound?
- Characteristic “honeycomb” or “snowstorm” appearance
- Presence of theca lutein cysts.
What βhCG level is suggestive of GTD?
Levels greater than two multiples of the median.
How is the definitive diagnosis of molar pregnancy made?
Through histological examination of the products of conception.
What is the method of choice for evacuating a complete molar pregnancy?
Suction curettage.
Is medical evacuation recommended for complete molar pregnancies?
No, it is avoided if possible.
What precautions are taken during evacuation of molar pregnancies?
- Senior supervision
- Avoiding oxytocic infusion prior to completion of evacuation.
Why is Anti-D prophylaxis required after molar pregnancy evacuation?
To prevent isoimmunization.