Molar pregnancy

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  • 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


Molar pregnancy on ultrasound
  • Serum hCG > 100,000 mIU/mL suggest excessive trophoblastic growth[1]
    • Normal hCG level does not exclude molar pregnancy
    • Partial molar pregnancies are more likely to produce lower hCG levels
  • Evaluate for other causes of or electrolyte derangements due to vomiting
  • Ultrasound: enlarged uterus with interspersed lucent and brighter areas ("snowstorm" appearance)


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


  • Admit

See Also

External Links


  1. Diagnosis and treatment of gestational trophoblastic disease: ACOG Practice Bulletin No. 53. Soper JT, Mutch DG, Schink JC, American College of Obstetricians and Gynecologists. Gynecol Oncol. 2004 Jun; 93(3):575-85.