which grows into a mass in the uterus.
Has chorionic villi which grow in clusters that resemble grapes.
('hydatis' from Greek = a droplet
referring to watery contents of the grape like cysts )
These structures appear to burrow into the wall of the uterus
hence the name mole.
Microscopically
hyperplasia of trophoblastic tissue .
Pathogenesis:
Develops when an egg that is missing its nucleus is fertilized.(molar pregnancy)
If left untreated
it will end as a spontaneous abortion .
Clinical: painless vaginal bleeding - 4th month
Diagnosis:
- U/S
- High HCG levels
Treatment: Evacuation by suction /curettage
Prognosis: Excellent in 80%
20% risk of developing choriocarcinoma.
Hence close follow-up till HCG returns to normal.
Persistent elevation of HCG = malignancy
Indications for chemotherapy:
� Elevated hCG levels after evacuation.
� Histological evidence of choriocarcinoma.
� Metastases in the brain
liver
vagina
vulva
1% chance of developing another molar pregnancy."