Molar Pregnancy

Question 1

Hydatidiform mole

Answer 1

Type of tumour that grows like a pregnancy inside the uterus

Question 2

Molar pregnancy

Answer 2

Presence of a hydatidiform

Question 3

Types of molar pregnancy

Answer 3

Complete mole

Partial mole

Question 4

How does a complete mole molar pregnancy occur

Answer 4

When 2 sperm cells fertilise an ovum that contains no genetic material (an “empty ovum”).

These sperm then combine genetic material, and the cells start to divide and grow into a tumour

No fetal material will form

Question 5

How does a partial mole occur

Answer 5

When 2 sperm cells fertilise a normal ovum (containing genetic material) at the same time

The new cell now has three sets of chromosomes (it is a haploid cell).

The cell divides and multiplies into a partial mole.

Some fetal material may form

Question 6

Investigations for a molar pregnancy

Answer 6

Pelvic USS

Biopsy and histology

Question 7

Presentation of a molar pregnancy

Answer 7

Secondary amenorrhoea

Pregnancy symptoms

Question 8

How to distinguish a molar pregnancy from a normal pregnancy

Answer 8

• More severe morning sickness
• Vaginal bleeding
• Increased enlargement of the uterus
• Abnormally high hCG
• Thyrotoxicosis (hCG can mimic TSH and stimulate the thyroid to produce excess T3 and T4)

Question 9

Sign of molar pregnancy on pelvic USS

Answer 9

Snowstorm appearance

Question 10

Management of a molar pregnancy

Answer 10

Evacuation of the uterus to remove the mole

Histological examination for confirmation

Referred to the gestational trophoblastic disease centre for management and follow up

hCG levels monitoring until they return to normal.

Question 11

Treatment for a metastatic mole

Answer 11

Chemotherapy