| ID | 316 |
|---|---|
| Name | HYDATIDIFORM MOLE |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | Investigation: 1. Pregnancy test- ‘+ve’ 2. Quantitative assay of urinary HCG (24 hours urinary HCG output). 3. Ultrasonogram- show storm appearance. |
| Management | |
| Introduction | Hydatidiform mole is the most common gesta-tional tumour. It is an abnormal pregnancy charac-terised by grape like structure filling & distending the uterus with the absence of an intact foetus. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | Treatment: 1. If the patient comes in the process of evacuation, than just hasten the process. 2. If the patient comes without evacuation stage, then- a. If height of uterus <12 weeks- D&C or M.R should be done. b. If height of uterus is in between 12-36 weeks- suction curettage should be done. Before suction curettage 40 units of syntoci-non should be given in 200ml of 5% D/A half-hour before evacuation. 1 week later check D&C shoud be done. 3. If patient’s age > 40 years- hysterectomy should be done in selected cases. Follow-up: upto 2 years-follow-up every 2 weeks interval until pregnancy test is negative, & urinary HCG becomes normal; then monthly for 1 year & 3-monthly from next year, atleast 7 visits. |
| Complications | |
| Prognosis | |
| Types | |
| Classification | Clinical feature: Symptoms: 1. Short period of amenorrhoea. 2. Signs and symptoms of early pregnancy. 3. Recurrent irregular vaginal bleeding. 4. Complaints of something (grape like structure) coming out per vagina. Signs: General Exam- 1. Patient is ill looking & toxic. 2. Anemia. 3. In 50% cases, sign of pre-eclamptic toxemia- e.g oedema, hypertension, proteinuria. P/A exam- 1. Uterus is enlarged than the corresponding period of amenorrhoea & uterus is doughy. 2. Foetal heart sound is absent & foetal parts are not palpable. P/Vexam- 1. Bilateral enlargement of ovaries (in 20-25% cases). 2. Vesicle may pass in uterine discharge. |
| Observation | |
| Pathology |
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