Molar pregnancy

Question 1

What is a hydatidiform mole?

Answer 1

Ahydatidiform moleis a type of tumour that grows like a pregnancy inside the uterus.

This is a form of gestational, trophoblastic disease which grows as a mass, characterised by swollen chorionic villi

Question 2

What are the 2 types of molar pregnancy

Answer 2

Complete mole
Partial mole

Question 3

What is a complete mole

Answer 3

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 into a tumour called acomplete mole. No fetal material will form.

The sperm then reduplicates to form a complete 46 chromosome set, however, only paternal DNA is present

Question 4

What is a partial mole

Answer 4

two sperm cells fertilise a normal ovum (containing genetic material) at the same time. The new cell now has three sets of chromosomes. The cell divides and multiplies into a tumour called apartial mole. In a partial mole, some fetal material may form.

Forming a 69 XXY (Triploid) cell, containing both maternal and paternal DNA

Question 5

Symptoms of molar pregnancy

Answer 5

• Vaginal bleeding
• Hyperemesis
• Pre-eclampsia (Rare)
• Enlarged uterus

Question 6

Risk of ectopic pregnancy

Answer 6

Malignant transformation to choriocarcinoma

Question 7

What are some differences between normal pregnancy and molar pregnancy

Answer 7

• 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 8

How is molar pregnancy diagnosed?

Answer 8

USS showing snowstorm appearance

Question 9

Management of molar pregnancy

Answer 9

evacuation of the uterus
HCG monitoring
Chemotherapy if malignant transformation