Molar pregnancy

Question 1

What is another term for a molar pregnancy?

Answer 1

Hydatidiform mole

Question 2

What is a hydatidiform mole?

Answer 2

Benign tumour of trophoblastic material

Question 3

What is a hydatidiform mole due to?

Answer 3

An imbalance in the number of chromosomes from the mother and father-46 chromosomes are of paternal origin

Question 4

How many chromosomes of parental origin are in a hydatidiform mole?

Answer 4

46 chromosomes are of paternal origin

Question 5

Which women are at a greater risk of a molar pregnancy?

Answer 5

Those at the ends of the age of fertility (under 16 and over 45).

Question 6

What are the two forms of a molar pregnancy?

Answer 6

A complete mole
A partial mole

Question 7

What is a partial mole formed from?

Answer 7

2 sperm and a normal egg

Question 8

What is present in a partial mole?

Answer 8

Both paternal and maternal genetic material is present

Question 9

What is there variable evidence of in a molar pregnancy?

Answer 9

Variable evidence of foetal parts.

Question 10

What is a complete mole formed from?

Answer 10

1 sperm and an empty egg with no genetic material

Question 11

How many chromosomes is a complete mole made up of?

Answer 11

46 chromosomes- The sperm then replicates to give a normal number of chromosomes

Question 12

Is there fetal tissue present in a complete mole?

Answer 12

No

Question 13

What are the main features of a molar pregnancy?

Answer 13

bleeding in first or early second trimester
exaggerated symptoms of pregnancy e.g. hyperemesis
uterus large for dates
very high serum levels of human chorionic gonadotropin (hCG)
hypertension and hyperthyroidism* may be seen

Question 14

When does bleeding typically occur in someone with a molar pregnancy?

Answer 14

First or early second trimester

Question 15

How does the uterus present in someone with a molar pregnancy?

Answer 15

Large for the gestational date

Question 16

What are there high levels of in the serum of someone with a molar pregnancy?

Answer 16

High serum levels of hCG

Question 17

What other symptom of pregnancy may be present in someone having a molar pregnancy?

Answer 17

Hyperemesis gravidarum

Question 18

How can a molar pregnancy be diagnosed?

Answer 18

B-hCG levels- high
Trans-vaginal ultrasound (for complete mp)

Question 19

What might you see on a transvaginal US of someone with a complete molar pregnancy?

Answer 19

A ‘snowstorm’ appearance, low resistance of blood vessel flow, and absence of a foetus.

Question 20

What is the management of a molar pregnancy?

Answer 20

urgent referral to specialist centre - evacuation of the uterus is performed
effective contraception is recommended to avoid pregnancy in the next 12 months

Question 21

What is the first line management of a molar pregnancy?

Answer 21

suction curettage to remove them from the uterus

Question 22

What is the management of a molar pregnancy when fertility doesn’t need to be preserved?

Answer 22

Hysterectomy can be done

Question 23

How is a patient monitored after the management of a molar pregnancy?

Answer 23

Two weekly serum and urine hCG until levels are normal