Molar pregnancy Flashcards
what is a molar pregnancy?
-Abnormal form of pregnancy in which a non viable fertilized egg implants in the uterus (or tube)
-commonest form of gestational trophoblastic diseases characterised by swollen chorionic villi
what is a complete mole?
A complete mole occurs when two 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 forming a tumour
do complete moles have maternal or paternal DNA in them?
only paternal DNA
what are partial moles?
Partial mole occurs when two sperm cells fertilise a normal ovum (containing genetic material) at the same time
-The cell divides and multiplies into a tumour
how many set of chromosomes does a partial mole have?
3 sets of chromosomes
-its a triploid cell!
(fertilised by 2 haploid)
do partial moles have maternal or parental DNA?
partial moles have both maternal and paternal DNA
what has more of a chance of becoming a choriocarcinoma?
complete mole
how is a partial/ complete mole characterised compared to other trophoblastic diseases?
characterised by its overgrowth of placental tissue with chorionic villi swollen with fluid; giving picture of ‘grape like clusters’
symptoms of molar pregnancy?
Behaves like a normal pregnancy
-Period will stop
- Hormonal changes will occur
Symptoms:
-More severe morning sickness
-Vaginal bleeding
-Increased enlargement of uterus
-Abnormally high hCG
-Thyrotoxicosis (hCG can mimic TSH and stimulate thyroid to produce excess T3 and T4 so can have hyperthyroidism symptoms)
how would molar pregnancy look on biopsy?
-Fluid filled villus
-Very big chorionic villus
-Loose stroma
-Trophoblast proliferating in stroma
how does a molar pregnancy appear on USS?
snowstorm appearance
what is used to diagnose a molar pregnancy?
US can be used for provisional diagnosis but needs to be confirmed with evacuation and biopsy
what are the biochemical markers seen in molar pregnancy?
-Very high beta HCG
-positive pregnancy test
-hCG can mimic TSH and stimulate thyroid to produce excess T3 and T4 (can give symptoms of hyperthyroidism)
what is the management for molar pregnancy?
Surgical procedure (uterine evacuation) and tissue sent for histology to ascertain type
After evacuation of a hydatidiform mole, the levels of b-hCG are expected to fall and pregnancy should be avoided for 1 year
-If they fail to drop, malignant choriocarcinoma should be suspected
what should be done even after the molar pregnancy has been treated?
After evacuation of a hydatidiform mole, the levels of b-hCG are expected to fall and pregnancy should be avoided for 1 year
-If they fail to drop, malignant choriocarcinoma should be suspected
