Molar Pregnancy Flashcards
What is a molar pregnancy?
From conception there is an imbalance in the number of chromosomes from the mother and father.
What is a molar pregnancy also known as?
Hydatidiform mole
What is the main risk factor of a molar pregnancy?
Those at either end s of the age of fertility
What age groups are most at risk of a molar pregnancy?
Under 16
Over 45
What are the 2 types of mole?
Complete mole
Partial Mole
What is a complete mole formed from?
1 Sperm and an empty egg
Is there any genetic material in a complete mole?
No
What does the sperm replicate to give in a complete mole?
It replicates to give a normal number of chromosomes
What are all the chromosomes in a complete mole?
Chromosomes of paternal origin
Is there any foetal tissue present with a complete mole/
No
What is a complete mole composed of?
A proliferation of swollen chorionic villi
What is a partial mole?
2 sperms and a normal egg
What genetic material is present?
Both paternal and maternal
What is there evidence of in a partial mole?
Foetal parts
How does a molar pregnancy present?
Vaginal bleeding
Nausea
Hyperemesis gravidarum
Thyrotoxicosis
How is the uterus affected in a molar pregnancy?
Uterus is larger than expected for gestational age
Why is the uterus so large in a molar pregnancy?
Due to excessive growth of trophoblasts and retained blood
What investigations would you carry out for a molar pregnancy?
B-hCG
Transvaginal ultrasound
How would the levels of B-hCG suggest a molar pregnancy?
They levels would be higher than in a normal pregnancy
What would a transvaginal ultrasound show in a a complete molar pregnancy?
A ‘snowstorm’ appearance
Low resistance of blood vessel flow
Absence of a foetus
What would be the first step in the management of a molar pregnancy?
Urgent referral to a specialist centre for treatment to reduce complications
How is a molar pregnancy managed?
Suction curettage to remove them from the uterus
How can a molar pregnancy be managed in fertility doesn’t need to be preserved?
Hysterectomy
What are possible complications of a molar pregnancy?
Choriocarcinoma
Invasion from developing
What surveillance is recommended in a molar pregnancy?
Two weekly serum and urine hCG until levels are normal
With a partial mole, when is hCG done?
4 weeks later
In a complete mole, how often is hCG done?
Repeat samples for at least 6 months
