Molar pregnancy: Difference between revisions

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Due primarily to elevated levels of hCG
Due primarily to elevated levels of hCG
*[[Vaginal bleeding in pregnancy (less than 20wks)|Vaginal bleeding]] (75-95%)
*[[Vaginal bleeding in pregnancy (less than 20wks)|Vaginal bleeding]] (75-95%)
*[[Hyperemesis gravidarum]] (26%]]
*[[Hyperemesis gravidarum]] (26%)
*[[Hypertension]], [[preeclampsia]]
*[[Hypertension]], [[preeclampsia]]
**Suspect molar pregnancy when pregnancy-induced hypertension occurs at <24 weeks
**Suspect molar pregnancy when pregnancy-induced hypertension occurs at <24 weeks

Revision as of 11:09, 21 November 2017

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