Molar Pregnancy

Question 1

What causes a molar pregnancy?

Answer 1

2 sperms fertilising an ovum

OR

A sperm fertilising an ovum that has no chromosomes

Question 2

What is the pattern of pathology in a molar pregnancy?

Answer 2

Ovum fertilised with chromosomal imbalance

Overgrowth of trophoblast cells –> pre-cancerous state

Hydatidiform mole forms

b-HCG secreted in high quantities

Question 3

What is a hydatidiform mole?

Answer 3

Syncitiotrophoblasts that secrete very high levels of b-HCG

Question 4

What can be caused by a hydatidiform mole?

Answer 4

Gestational trophoblastic neoplasia (GTN)

Question 5

What is the presentation of a molar pregnancy?

Answer 5

Early pregnancy bleeding

• Pallor
• Tachycardia + hypotension + peripheral oedema

Severe nausea
- Hyperemesis gravidarum

Question 6

Investigations of molar pregnancy?

Answer 6

Bloods

USS

Question 7

What bloods should be done for mole

Answer 7

b-HCG levels

FBC

Question 8

What might be seen on blood tests?

Answer 8

Very very high b-HCG

Anaemia

Question 9

What might be seen on USS?

Answer 9

Snowstorm appearance w/ large uterus

MUST ASSESS FOR MULTIPLE PREGNANCY

Question 10

Management of molar pregnancy?

Answer 10

Oxytocin given IV then

Surgery
- Dilatation and evacuation

Question 11

What should be done in molar with no fertility desire?

Answer 11

Hysterectomy