Molar pregnancy: Difference between revisions

Line 24: Line 24:
**[[Cervicitis]]
**[[Cervicitis]]
**Gestational trophoblastic disease
**Gestational trophoblastic disease
*[[Nausea Vomiting in Pregnancy]]
 
**[[Biliary disease]], hepatic disease (e.g. fatty liver of pregnancy, [[HELLP syndrome]]
{{NV in pregnancy DDX}}
**[[Pancreatitis]]
**[[Appendicitis]]
**[[Hepatitis]]
**[[Gastroenteritis]]
**[[Pyelonephritis]]
**[[Thyrotoxicosis]]


==Evaluation==
==Evaluation==

Revision as of 15:54, 10 November 2016

Background

  • Type of gestational trophoblastic disease
    • Neoplasm of placental hCG-producing trophoblast cells
    • Non-invasive (invasive form is choriocarcinoma, can metastasize to brain, liver, lung)
  • Non-viable fertilized egg implants in uterine wall
    • Complete: all chorionic villi are vesicular, swollen, with no embryonic development
    • Partial: some vesicular chorionic villi, +/- (nonviable) embryonic development

Clinical Features

Due primarily to elevated levels of hCG

Differential Diagnosis

Nausea and vomiting in pregnancy

Evaluation

Molar pregnancy on ultrasound
  • Serum hCG
  • Evaluate for other causes of or electrolyte derangements due to vomiting
  • Ultrasound: enlarged uterus with interspersed lucent and brighter areas ("snowstorm" appearance)

Management

  • Ob/gyn consult
    • Suction curettage as inpatient (due to risk of bleeding)
  • Resuscitate if severe bleeding
  • Treat preeclampsia
  • Symptomatic resuscitation of nausea/vomiting

Disposition

  • Admit

See Also

External Links

References