Trophoblastic disease

Question 1

What is a hydatidiform mole?

Answer 1

Developmental abnormality of the placenta, a mass of “grapelike” vesicles in the uterus

Question 2

How do complete molar pregnancies differ from partial?

Answer 2

Complete-all genetic material comes from father (an “empty” ovum fertilised by sperm)
Partial- triploid trophoblastic cells, due to two sperm fertilising the egg at the same time

Question 3

How can hydatidiform moles cause haemorrhage?

Answer 3

Invade the myometrium

Question 4

Which kind of cancer can hydatidiform moles develop into?

Answer 4

Choriocarcinoma

Question 5

Clinical features of hydatidiform moles (5)

Answer 5

Amenorrhoea
Vaginal bleeding
Large uterus
Hyper-emesis
Pre-eclampsia

Question 6

Investigations in suspected hydatidiform mole (2)

Answer 6

Urinary and serum hCG is markedly elevated

Ultrasound- “snowstorm” appearance, theca lutein cysts

Question 7

Management of hydatidiform mole (4)

Answer 7

Suction curettage
Follow up- urinary and serum hCG
May require chemotherapy
Barrier contraception until hCG normalised