Molar pregnancy

Question 1

What is a hydatidiform mole?

Answer 1

• type of tumour that grows like a pregnancy inside the uterus
• this is called a molar pregnancy
• two types of molar pregnancy: complete and partial mole

Question 2

What is a complete mole?

Answer 2

• when two sperm cells fertilise an ovum with no genetic material and then combine genetic material resulting in the cells dividing and growing into a tumour called a complete mole
• no fetal matter forms

Question 3

What is a partial mole?

Answer 3

• when two sperm cells fertilise a normal ovum containing genetic material at the same time
• new cell formed now has three sets of chromosomes (haploid cell_ and so divides and multiplies into a tumour called a partial mole
• some fetal matter may form

Question 4

What signs and symptoms can differentiate a molar pregnancy from a normal one?

Answer 4

• more severe morning sickness
• vaginal bleeding
• increased enlargement of the uterus
• abnormally high hCG
• thyrotoxicosis as hCG can mimic TSH

Question 5

What would a pelvic US show in a molar pregnancy?

Answer 5

• characteristic snowstorm appearance of the pregnancy

- diagnosis can then be confirmed with histology of mole after evacuation

Question 6

What does management of a molar pregnancy involve?

Answer 6

• evacuation of the uterus to remove the mole
• histological examination to confirm molar pregnancy
• Patients should be referred to the gestational trophoblastic disease centre for management and follow up
• hCG monitored until normal
• Occasionally the mole can metastasise, and the patient may require systemic chemotherapy.