Molar pregnancy Flashcards
What is another term for a molar pregnancy?
Hydatidiform mole
What is a hydatidiform mole?
Benign tumour of trophoblastic material
What is a hydatidiform mole due to?
An imbalance in the number of chromosomes from the mother and father-46 chromosomes are of paternal origin
How many chromosomes of parental origin are in a hydatidiform mole?
46 chromosomes are of paternal origin
Which women are at a greater risk of a molar pregnancy?
Those at the ends of the age of fertility (under 16 and over 45).
What are the two forms of a molar pregnancy?
A complete mole
A partial mole
What is a partial mole formed from?
2 sperm and a normal egg
What is present in a partial mole?
Both paternal and maternal genetic material is present
What is there variable evidence of in a molar pregnancy?
Variable evidence of foetal parts.
What is a complete mole formed from?
1 sperm and an empty egg with no genetic material
How many chromosomes is a complete mole made up of?
46 chromosomes- The sperm then replicates to give a normal number of chromosomes
Is there fetal tissue present in a complete mole?
No
What are the main features of a molar pregnancy?
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
When does bleeding typically occur in someone with a molar pregnancy?
First or early second trimester
How does the uterus present in someone with a molar pregnancy?
Large for the gestational date
What are there high levels of in the serum of someone with a molar pregnancy?
High serum levels of hCG
What other symptom of pregnancy may be present in someone having a molar pregnancy?
Hyperemesis gravidarum
How can a molar pregnancy be diagnosed?
B-hCG levels- high
Trans-vaginal ultrasound (for complete mp)
What might you see on a transvaginal US of someone with a complete molar pregnancy?
A ‘snowstorm’ appearance, low resistance of blood vessel flow, and absence of a foetus.
What is the management of a molar pregnancy?
urgent referral to specialist centre - evacuation of the uterus is performed
effective contraception is recommended to avoid pregnancy in the next 12 months
What is the first line management of a molar pregnancy?
suction curettage to remove them from the uterus
What is the management of a molar pregnancy when fertility doesn’t need to be preserved?
Hysterectomy can be done
How is a patient monitored after the management of a molar pregnancy?
Two weekly serum and urine hCG until levels are normal
