hrge in early pregnancy

Question 1

wht is heterotopic pregnancy

Answer 1

pregnancy present both in uterine + ectopic ( tube / cervix )

Question 2

diagnostic criteria of heterotopic pregnancy

Answer 2

HCG levels higher than gestational age

persistently high HCG despite termination of pregnancy

usg showing both uterine and ectopic pregnancy

Question 3

which layer of chorionic villi secrete HCH AND HPL

Answer 3

syntiotrphoblast

Question 4

wht is funisitis

Answer 4

inflammation of umblical cord

Question 5

most common cause of late pregnancy bleeding

Answer 5

abruptio placentae is most common cause

Question 6

placenta previa causes ____ bleeding

abruptio placentae causes ____ bleeding

Answer 6

painless

painful

Question 7

chromosomal pattern of complete h mole

and partial h mole

Answer 7

COMPLETE H MOLE
ovum lacks maternal chromosomes empty ovum
chromosomes r paternally derived
》duplication of paternal chromosomes 46 + XX
》Fusion of egg by two sperms dispermy
46+XX/ 46+XY

PARTIAL H MOLE
triploid ovum 69+XXY

Question 8

USG appearence of complete mole

Answer 8

SNOWSTORM APPEARENCR

Question 9

which is hving more risk of çhoriocarcinoma

complete / incomplete

Answer 9

complete mole is at more risk

Question 10

gestational tumor with increased placental lactogen but decreased hcg

Answer 10

placental site trophoblatic tumor

Question 11

white currant in red currant juice is seen in ?

Answer 11

vagianl bleeding seen in h mole

Question 12

cause of pain in hmole

Answer 12

invasive mole
overstretched uterus
concealed hrge
uterine contractions

Question 13

diagnostic clinical feature of hmole is

Answer 13

expulsions of grape like vesicles per vaginum

Question 14

clinical features of h mole

Answer 14

vaginal bleeding 
lower abdominal pain 
⬆️ vomiting 
breathlessness due to pulmonary embolism of trophoblatic cells 
expulsion of grape like vesicles per vaginum 
uterus > dates 
no fetal parts 
serum HCG more than 100000
SNOWSTORM APPEARANCES ON USG

Question 15

differential diagnostes of hmole

Answer 15

THREATNED ABORTIONS due to dark colured vaginal discharge + mistaken dates with increased uterine size

FIBROID disproportionate increase in size

MULTIPLE PREGNANCY DUE tp preeclampsia early , increased B hcg ,

twin pregnancy with one normal and other complete mole mimics partial mole

Question 16

risk for malignant change of hmole

Answer 16

•pt age > 40 yrs \ pt age < 20yrs
•parity > 3 
•hcg > 100000
•uterine size > 20 wks 
•previous history of hmole 
theca lutein cysts > 6cm

Question 17

does chemotherapy for hmole increases risk for foetal malformation

Answer 17

no

Question 18

complications of molar pregnancy

Answer 18

immediate 
• hrge and shock 
• sepsis 
• perforation of uterus 
• preeclampsia 
• acute pulmonary insufficiency 
•coagulation failure 

LATE
• CHORIOCCARCINOMA

Question 19

most common site of ectopic pregnancy

Answer 19

ampulla