Molar pregnancy

Question 1

Explain to patient how a molar pregnancy occurs.

Answer 1

Partial mole: an ovum containing maternal genes is fertilised by two sperm.

Complete mole: an empty ovum that does not contain maternal genes is fertilised by either two sperm or a single sperm that duplicates.

Question 2

Outline counselling when new diagnosis of molar pregnancy is made on histology

Answer 2

• Explain what molar is
• Follow-up due to risk of malignant transformation (<5 partial mole vs 20% complete mole)
• Baseline investigations: CXR, FBC, tumour BhCG, LFTs, U&Es
• Contraception: barrier, OCPs
• Referral to gynae onc or register.
• Future pregnancies: 1st trimester USS, histology for all POC, 6 week postpartum hCG level, +/- placenta histology.
• Risk of recurrence: 1% 1 prev, 25% 2 prev