Gynae Emergency

Question 1

What is Molar pregnancy?

Answer 1

Non viable fertilized egg implants on the uterus. Fluid filled vesicle developed instead of placenta.

Question 2

What is the clinical features of molar pregnancy?

Answer 2

• Short period of ammonorhea with
• Excessive pregnancy sx ( Hyperemesis gravidarum) & pre-eclampsia sx
• present with Abdominal pain, Vaginal Bleding,

Question 3

What is the sign of molar pregnancy

Answer 3

A) General
-Toxic looking
-Dehydrated ( H.G sx)
-Dyspnea
-Tachycardia
-Low B.P

Per abdominal
-Doughy abdomen
-Uterus bigger than date

Per vaginal
-Vaginal bleeding
-Grape like cluster on passage of vagina

Question 4

What is the investigation of M.P

Answer 4

1) Baseline investigation
- Hb
-stereotyping
-Coagulation profile
-Rh factor
-b hCG level( extremely high 100,00)I
-thyroxin( in case on hyperthyroidism)

2) Imaging
-USG (honeycomb like appearance/snowstorm pattern)

Question 5

What is the treatment of molar pregnancy?

Answer 5

1) Resus if pt in shock

2) supportive tx: oral/iv maxolon ( anti emetic)

3) suction evacuation under GA

4) Discharge if stable… with follow up once every week to monitor the b-hCG( supposeldy decrease)

5) if not decreasing give methotrexate.

6) if still rise try methotrexate.. if still not resolved give
Dactinomycin ,