Hydatidiform mole

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Hydatidiform mole is a rare mass or growth that forms inside the womb (uterus) at the
beginning of a pregnancy !t is a type of gestational trophoblastic disease ("#$) % cancerous
form of "#$ is called choriocarcinoma
Causes
Hydatidiform mole& or molar pregnancy& results from over-production of the tissue that is
supposed to develop into the placenta #he placenta feeds the fetus during pregnancy 'ith a
molar pregnancy& the tissues develop into an abnormal growth& called a mass
#here are two types(
Partial molar pregnancy( #here is an abnormal placenta and some fetal development
)omplete molar pregnancy( #here is an abnormal placenta but no fetus
Both forms are due to problems during fertili*ation #he e+act cause of fertili*ation
problems is unknown % diet low in protein& animal fat& and vitamin % may play a role
Symptoms
%bnormal growth of the womb (uterus)
o ,+cessive growth in about half of cases
o Smaller-than-e+pected growth in about a third of cases
-ausea and vomiting that may be severe enough to re.uire a hospital stay
/aginal bleeding in pregnancy during the first 0 months of pregnancy
Symptoms of hyperthyroidism
o Heat intolerance
o 1oose stools
o 2apid heart rate
o 2estlessness& nervousness
o Skin warmer and more moist than usual
o #rembling hands
o 3ne+plained weight loss
Symptoms similar to preeclampsia that occur in the 4st trimester or early 5nd
trimester -- this is almost always a sign of a hydatidiform mole& because preeclampsia
is e+tremely rare this early in a normal pregnancy
o High blood pressure
o Swelling in feet& ankles& legs
Exams and Tests
% pelvic e+amination may show signs similar to a normal pregnancy& but the si*e of the
womb may be abnormal and the baby6s heart sounds are absent #here may be some vaginal
bleeding
% pregnancy ultrasound will show an abnormal placenta with or without some development
of a baby
#ests may include(
H)" blood test
)hest +-ray
)# or 72! of the abdomen
)omplete blood count
Blood clotting tests
8idney and liver function tests
Treatment
!f your doctor suspects a molar pregnancy& a suction curettage ($ and )) may be performed
% hysterectomy may be an option for older women who do not wish to become pregnant in
the future
%fter treatment& serum H)" level will be followed !t is important to avoid pregnancy and to
use a reliable contraceptive for 9 - 45 months after treatment for a molar pregnancy #his
allows for accurate testing to be sure that the abnormal tissue does not grow back 'omen
who get pregnant too soon after a molar pregnancy have a high risk of having another molar
pregnancy
Outlook (Prognosis)
7ore than :;< of hydatidiform moles are benign (noncancerous) #reatment is usually
successful )lose follow-up by your doctor is important %fter treatment& use effective
contraception for at least 9 - 45 months to avoid pregnancy
!n some cases& hydatidiform moles develop into invasive moles #hese can grow deep into the
uterine wall and cause bleeding or other complications
!n a few cases& a hydatidiform mole develops into a choriocarcinoma #his is a fast-growing
cancerous form of gestational trophoblastic disease
Possible Complications
1ung problems may occur after a $ and ) if the mother6s uterus is larger than 49 weeks
gestational si*e
)omplications of molar pregnancy include(
Preeclampsia
#hyroid problems
7olar pregnancy that continues or comes back
)omplications related to the surgery to remove a molar pregnancy include(
,+cessive bleeding
Side effects of anesthesia
Alternatie !ames
Hydatid mole= 7olar pregnancy
"eferences
)opeland 1>& 1andon 7B 7alignant diseases and pregnancy !n( "abbe S"& -iebyl >2&
Simpson >1& eds Obstetrics - Normal and Problem Pregnancies 9th ed Philadelphia& Pa(
,lsevier Saunders= 5;45(chap ?@
"oldstein $P& Berkowit* 2S "estational trophoblastic disease !n( %beloff 7$& %rmitage
>A& -iederhuber >,& 8astan 7B& 7c8enna '"& eds Abeloffs Clinical Oncology ?th ed
Philadelphia& Pa( ,lsevier )hurchill 1ivingstone= 5;;:(chap B?
8avanagh >>& "ershenson $7 "estational trophoblastic disease( hydatidiform mole&
nonmetastatic and metastatic gestational trophoblastic tumor( diagnosis and management !n(
8at* /1& 1ent* "7& 1obo 2%& "ershenson $7& eds Comprehensive Gynecology 9th ed
Philadelphia& Pa( ,lsevier 7osby= 5;45(chap 0C
#pdate $ate% &&'(')*&)
3pdated by( Susan Storck& 7$& D%)A"& )hief& ,astside $epartment of Abstetrics and
"ynecology& "roup Health )ooperative of Puget Sound& Bellevue& 'ashington= )linical
#eaching Daculty& $epartment of Abstetrics and "ynecology& 3niversity of 'ashington
School of 7edicine %lso reviewed by %$%7 Health Solutions& ,bi+& !nc& ,ditorial
#eam( $avid Eieve& 7$& 7H%& $avid 2 ,lt*& Stephanie Slon& and -issi 'ang