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Hydatidiform mole A hydatidiform mole is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy

. It is a type of gestational trophoblastic disease (GTD). See also:


Gestational trophoblastic disease Choriocarcinoma (a cancerous form of GTD)

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Causes

Loose stools Rapid heart rate Restlessness, nervousness Skin warmer and more moist than usual Trembling hands Unexplained weight loss Symptoms similar to preeclampsia that occur in the 1st trimester or early 2nd trimester -- this is almost always a sign of a hydatidiform mole, because preeclampsia is extremely rare this early in a normal pregnancy o High blood pressure o Swelling in feet, ankles, legs

o o o o o o

In a few cases, a hydatidiform mole may develop into a choriocarcinoma, a fast-growing cancerous form of gestational trophoblastic disease. See: Choriocarcinoma Possible Complications Lung problems may occur after a D and C if the woman's uterus is bigger than 16 weeks gestational size. Alternative Names Hydatid mole; Molar pregnancy

Exams and Tests A hydatidiform mole, or molar pregnancy, results from overproduction of the tissue that is supposed to develop into the placenta. The placenta normally feeds a fetus during pregnancy. In this condition, the tissues develop into an abnormal growth, called a mass. There are two types: Gestational trophoblastic disease A pelvic examination may show signs similar to a normal pregnancy, but the size of the womb may be abnormal and the baby's heart sounds are absent. There may be some vaginal bleeding. A pregnancy ultrasound will show an abnormal placenta with or without some development of a baby. Tests may include: There are several types of GTD. They include: Gestational trophoblastic disease (GTD) refers to a group of abnormalities in which tumors grow inside a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta, the organ that develops during pregnancy to feed the fetus. A baby may or may not develop during these types of pregnancies. Partial molar pregnancy Complete molar pregnancy

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A partial molar pregnancy means there is an abnormal placenta and some fetal development. In a complete molar pregnancy, there is an abnormal placenta but no fetus. Both forms are due to problems during fertilization. Potential causes may include defects in the egg, problems within the uterus, or a diet low in protein, animal fat, and vitamin A. Women under age 16 or older than 40 have a higher risk for this condition. You also are more likely to have a molar pregnancy if you have had one in the past. Symptoms

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HCG blood test Chest x-ray CT or MRI of the abdomen

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Choriocarcinoma (a type of cancer) Hydatiform mole (also called a molar pregnancy)

Treatment If your doctor suspects a molar pregnancy, a suction curettage (D and C) may be performed. A hysterectomy may be an option for older women who do not wish to become pregnant in the future. After treatment, serum HCG levels will be followed. Outlook (Prognosis) More than 80% of hydatidiform moles are benign (noncancerous). The outcome after treatment is usually excellent. Close follow-up is essential. After treatment, you should use very effective contraception for at least 6 to 12 months to avoid pregnancy. In some cases, hydatidiform moles may develop into invasive moles. These moles may grow so far into the uterine wall and cause bleeding or other complications.

Choriocarcinoma Choriocarcinoma is a quick-growing form of cancer that occurs in a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta, the organ that develops during pregnancy to feed the fetus. Choriocarcinoma is a type of gestational trophoblastic disease. See also:

  

Abnormal growth of the womb (uterus) o Excessive growth in about half of cases o Smaller-than-expected growth in about a third of cases Nausea and vomiting that may be severe enough to require a hospital stay Vaginal bleeding in pregnancy during the first 3 months of pregnancy Symptoms of hyperthyroidism o Heat intolerance

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Causes

Gestational trophoblastic disease Hydatiform mole

Choriocarcinoma is an uncommon, but very often curable cancer associated with pregnancy. A baby may or may not develop in these types of pregnancy.

however. abnormalities within the uterus. Symptoms A possible symptom is continued vaginal bleeding in a woman with a recent history of hydatidiform mole. a partial mole occurs when a normal egg is fertilized by two spermatozoa. wherein a non-viable. hyperplasia of the trophoblastic tissue is noted. Prevention Imaging tests that may be done include:   CT scan MRI Careful monitoring after the removal of hydatidiform mole or termination of pregnancy can lead to early diagnosis of a choriocarcinoma. Potential risk factors may include defects in the egg. Possible Complications A choriocarcinoma may come back after treatment. fertilized egg implants in the uterus. or genital tumor. referring the watery contents of the cysts. Based on morphology. and no sign of embryonic or fetal development is present. abortion. hydatidiform moles can be divided into two types: In complete moles. The vesicles arise by distention of the chorionic villi by fluid. and mole (from Latin mola = millstone/false conception). Hydatidiform moles are a common complication of pregnancy. Chemotherapy is the main type of treatment. usually within several months but possibly as late as 3 years. whereas others appear more normal. A hysterectomy and radiation therapy are rarely needed. [1] Molar pregnancies are categorized into partial and complete moles. Trophoblastic tumor.The cancer may develop after a normal pregnancy. The abnormal tissue from the mole can continue to grow even after it is removed and can turn into cancer.[3] The term. Women under 20 or          Irregular vaginal bleeding Ovarian cysts Uneven swelling of the uterus Pain Disease has spread to the liver or brain Pregnancy hormone (HCG) level is greater than 40. complete moles have no identifiable embryonic or fetal tissues and arise when an empty egg with no nucleus is fertilized by a normal sperm. Choriocarcinomas may also occur after an abortion. The to etymology is derived from hydatis (Greek "a drop of water"). occurring once in every 1000 pregnancies in the US. If left untreated. In partial moles some villi are vesicular. which improves outcome. Alternative Names Chorioblastoma.[7] The etiology of this condition is not completely understood. and thereby converts normal pregnancy processes into pathological ones. comes from the similar appearance of the cyst to a hydatid cyst in an Echinococcosis[4]. When inspected in the microscope. or term pregnancy. a hydatidiform mole will almost always end as a spontaneous abortion. The uterus contains two conceptuses: one with an abnormal placenta and no viable fetus (the mole). A pelvic examination may reveal continued uterine swelling or a tumor. all the chorionic villi are vesicular. Gestational trophoblastic neoplasi Treatment After an initial diagnosis. mola hydatidosa). When to Contact a Medical Professional     Quantitative serum HCG Complete blood count Kidney function tests Liver function tests Call for an appointment with your health care provider if symptoms arise within 1 year after hydatidiform mole. Chorioepithelioma. however.[6] In rare cases a hydatidiform mole co-exists in the uterus with a normal. see cancer resources. a form of cancer. The condition is harder to cure if the cancer has spread and one of more of the following events occur: Hydatidiform mole Molar pregnancy is an abnormal form of pregnancy. viable fetus. Under careful surveillance it is often possible for the woman to give birth to the normal child and to be cured of the mole. A hydatidiform mole conception is sometimes referred to colloquially as an early (natural) "missed abortion. About half of all women with a choriocarcinoma had a hydatidiform mole. in contrast. or pregnancy. a careful history and examination are done to make sure the cancer has not spread to other organs. or molar pregnancy.000 mIU/mL at the time treatment begins Having received chemotherapy in the past Symptoms or pregnancy occurred for more than 4 months before treatment began Choriocarcinoma occurred after a pregnancy that resulted in the birth of a child Exams and Tests A pregnancy test will be positive even when you are not pregnant. or nutritional deficiencies. with much higher rates in Asia (e. abortion (including miscarriage). it is most often associated with a complete hydatidiform mole. up to one in 100 pregnancies in Indonesia). .g. Complications associated with chemotherapy can also occur. and embryonic/fetal development may be seen but the fetus is always malformed and is never viable. Pregnancy hormone (HCG) levels will be persistently high. It's characterized by the presence of a hydatidiform mole (or hydatid mole. Additional symptoms may include: Support Groups For additional information. and one with a normal placenta and a viable fetus. These cases are due to twinning."[5] Natural history A hydatidiform mole is a pregnancy/conceptus in which the placenta contains grapelike vesicles that are usually visible with the naked eye. [2] Hydatidiform moles may develop into choriocarcinoma. Outlook (Prognosis) Most women whose cancer has not spread can be cured and will maintain reproductive function. Blood tests that may be done include: Many women (about 70%) who initially have a poor outlook go into remission (a disease-free state). ectopic pregnancy.

[16] Patients are followed up until their serum human chorionic gonadotrophin (hCG) level has fallen to an undetectable level. there are two copies of every chromosome). nervousness o Skin warmer and more moist than usual o Trembling hands o Unexplained weight loss Symptoms similar to preeclampsia that occur in the 1st trimester or early 2nd trimester -.[1] The uterus may be larger than expected. Both forms are due to problems during fertilization. Symptoms      Abnormal growth of the womb (uterus) o Excessive growth in about half of cases o Smaller-than-expected growth in about a third of cases Nausea and vomiting that may be severe enough to require a hospital stay Vaginal bleeding in pregnancy during the first 3 months of pregnancy Symptoms of hyperthyroidism o Heat intolerance o Loose stools o Rapid heart rate o Restlessness. Carboprost medication may be used to contract the uterus. Invasive or metastatic moles (cancer) may require chemotherapy and often respond well to methotrexate. or the ovaries may be enlarged. In both cases.[9] Parental origin In most complete moles. or a diet low in protein. Some of these moles occur in women who carry mutations in the gene NLRP7. and vitamin A. the tissues develop into an abnormal growth. the rate of cure after treatment with chemotherapy is high. as in normal living persons. Thus the nucleus contains one maternal set of genes and two paternal sets. In approximately 20% of complete moles the most probable mechanism is that an empty egg is fertilised by two sperms. The most probable mechanism is that a normal haploid egg is fertilized by two sperms. A small percentage of hydatidiform moles have biparental diploid genomes. or molar pregnancy. It is for this reason that a post-operative full abdominal and chest x-ray will often be requested. animal fat. and metastatic (spreading) form of cancer.[10][11][12] Clinical presentation and diagnosis Molar pregnancies usually present with painless vaginal bleeding in the fourth to fifth month of pregnancy. which is a malignant. In all these cases. There is increased trophoblast proliferation and enlarging of the chorionic villi.e. the mitochondrial genes are inherited from the mother. the moles are diploid (i. Causes A hydatidiform mole. called a mass. Potential causes may include defects in the egg.[13] The diagnosis is strongly suggested by ultrasound (sonogram). followed by a duplication of all chromosomes/genes (a process called "endoreduplication"). as usual. This leads to overgrowth of the syncytiotrophoblast whereas dual egg-patterned methylation leads to a devotion of resources to the embryo. In rare cases. one inherited from each biological parent. Over 90% of women with malignant. Hydatidiform Mole A hydatidiform mole is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy.over 40 years of age have a higher risk. In 10 to 15% of cases. non-spreading cancer are able to survive and retain their ability to conceive and bear children.this is almost always . In this condition. predisposing them towards molar pregnancy. In approximately 80% of these androgenetic moles. with an underdeveloped syncytiotrophoblast. There may also be more vomiting than would be expected (hyperemesis). there is an abnormal placenta but no fetus. all nuclear genes are inherited from the father only (androgenesis). although their childbearing ability is usually lost.[8] The diploid set of sperm-only DNA means that all chromosomes have spermpatterned methylation suppression of genes. The placenta normally feeds a fetus during pregnancy. in order to avoid the risks of choriocarcinoma. The moles may intrude so far into the uterine wall that hemorrhage or other complications develop. due to the extremely high levels of hCG. which can mimic the normal Thyroid-stimulating hormone (TSH). the mole resembles a bunch of grapes ("cluster of grapes" or "honeycombed uterus" or "snow-storm"[14]). The outcome after treatment is usually excellent. It is a type of gestational trophoblastic disease (GTD). Prognosis More than 80% of hydatidiform moles are benign. Blood tests will show very high levels of human chorionic gonadotropin (hCG). Despite these factors which normally indicate a poor prognosis. Highly effective means of contraception are recommended to avoid pregnancy for at least 6 to 12 months. but definitive diagnosis requires histopathological examination. and carotene. the most probable mechanism is that an empty egg is fertilized by a single sperm. they have two sets of chromosomes. In those with metastatic (spreading) cancer. In a complete molar pregnancy. Other risk factors include diets low in protein. This condition is named persistent trophoblastic disease (PTD). hydatidiform moles may develop into invasive moles. Sometimes there is an increase in blood pressure along with protein in the urine. remission remains at 75 to 85%. The chances of having another molar pregnancy are approximately 1%. You also are more likely to have a molar pregnancy if you have had one in the past. hydatidiform moles are tetraploid (four chromosome sets) or have other chromosome abnormalities. Most partial moles are triploid (three chromosome sets). folic acid. On ultrasound.[13] Treatment Hydatidiform moles should be treated by evacuating the uterus by uterine suction or by surgical curettage as soon as possible after diagnosis. problems within the uterus. results from overproduction of the tissue that is supposed to develop into the placenta. Close follow-up is essential. This is considered to be the result of evolutionary competition with male genes driving for high investment into the fetus versus female genes driving for resource restriction to maximise the number of children. The response to treatment is nearly 100%. [15] Sometimes symptoms of hyperthyroidism are seen. Management is more complicated when the mole occurs together with one or more normal fetuses. These rare variants of hydatidiform mole may be complete or partial. rapidly-growing.[15] Angiogenesis in the trophoblasts is impaired as well. In 2 to 3% of cases. There are two types:   Partial molar pregnancy Complete molar pregnancy A partial molar pregnancy means there is an abnormal placenta and some fetal development. Women under age 16 or older than 40 have a higher risk for this condition. hydatidiform moles may develop into choriocarcinoma. Patients are advised not to conceive for one year after a molar pregnancy.

pale mucosa. because preeclampsia is extremely rare this early in a normal pregnancy o High blood pressure o Swelling in feet. Face is symmetrical and symmetrical facial movement. IV’s and oral meds were continued given to her due to her high BP results. you should use very effective contraception for at least 6 to 12 months to avoid pregnancy. I. See: Choriocarcinoma Possible Complications On or about Sept. My group is also fond to know about the important things to consider and word to discuss about this case. J.Private Bed 6. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. Has thin eyebrows. External Female Reproductive System Escutcheonmons veneris/pubisclitorisskene’s gland (para urethral gland)vestibule bartholins gland (vulvo vaginal gland)hymenfourchettefrenulumlabia minora labia majoraperineumanus Internal Female Reproductive System FundusCorpusIsthmusovarian ligamentfallopian tube 4 parts of fallopian tube    HCG blood test Chest x-ray CT or MRI of the abdomen Treatment A. PATIENT HEALTH HISTORY The client stated that she had measles when she was 12 y/o. tenderness upon palpation. In a few cases. both patent but have watery secretion. Routine laboratory work-up was done like ultrasound. Close follow-up is essential. This fact must be evaluated carefully II. Outlook (Prognosis) More than 80% of hydatidiform moles are benign (noncancerous). PAST MEDICAL HISTORY . She also stated that they don’t have history of Diabetes. tongue is in midline.MouthThe lips are pale. A hysterectomy may be an option for older women who do not wish to become pregnant in the future.a sign of a hydatidiform mole. As the cells degenerate . with D5W 1L x 8° was administered. After treatment. There may be some vaginal bleeding.Upper ExtremitiesThere is resistance for muscle strength. The skin has scar.V. then Prior to admission she then experience high BP elevation and the doctor give him Catapres as relief to her condition. B. EyesThe client has straight normal eye condition. nonproductive (+) dyspneaShe was diagnosed with Molar Pregnancy. In some cases. The outcome after treatment is usually excellent. The doctors of SJMC make a plan that JV must undergo to a operation called HYSTERECTOMY. especially how to prevent. There is presence of scar and masses.Lower ExtremitiesThere is resistance for muscle strength. mucosa is pale. A pregnancy ultrasound will show an abnormal placenta with or without some development of a baby. Tuberculosis and other hereditary disease. consulted at East Avenue Medical Center. and ECG. the cervix. It is because she is suffering H-mole pregnancy. III. 2007 at 9:40 pm. Tests may include: Lung problems may occur after a D and C if the woman's uterus is bigger than 16 weeks gestational size. Then after the doctor has seen that she have relief from her condition. ankles.NoseThe nose is in septum is in midline. 14. Removal of the entire uterus and the cervix is referred to as a total hysterectomy. How it is start. G7P5 TPAL (5-0-1-5) C.diagnostic of multiple pregnancy or a miscalculated . pupil is black in color and equal in size. serum HCG levels will be followed. were in the patient will undergo to a certain operation A surgical operation to remove the uterus and. The skin has scar. PRESENT ILLNESS OR PRESENT HEALTH STATUS 2 Days PTA – (+) vaginal bleeding with hypogastric pain. No scars and hairs are evenly distributed. thick and evenly distributed. FAMILY HEALTH HISTORY The patient stated that her family has a history of Hypertension. sometimes. Removal of the body of the uterus without removing the cervix is referred to as a subtotal hysterectomy. Neck muscles are equal in size and no tenderness. These moles may grow so far into the uterine wall and cause bleeding or other complications. tenderness upon palpationAbdomenUniform in color. Placed on moderate high back rest. treat and manage the patient by giving medication for treatment and providing rapport. NeckThe skin is uniform in color.Breast and AxillaNo masses. E. dry and smooth.(+) cough. chest x-ray. She was placed on Delivery Room. The ovaries produce the eggs that travel through the fallopian tubes. She doesn’t smoke and drink alcohol. INTRODUCTION The purpose of this case study is to be familiar with Molar Pregnancy. D. symmetrical. Abdomen has an irregular enlargement unlilke on normal pregnancy. was admitted at San Juan Medical Center with chief complaint of vaginal bleeding.NailsLong and slightly dirtyHead and FaceThe skull is proportionate to body size. a hydatidiform mole may develop into a choriocarcinoma. The main function of the uterus is to nourish the developing fetus prior to birth. a suction curettage (D and C) may be performed. Symmetrical movement. PHYSICAL ASSESSMENT SkinUniform color with warm temperature. pain. she was the placed on Female Semi. but the size of the womb may be abnormal and the baby's heart sounds are absent. After treatment. She doesn’t have any allergies and past injuries. Hair is oily.they become filled with fluid .We chose this case study because this is the first time we’ve encountered in the entire rotation and because some of the patient in OB Female semi-private room (FSPR) are Normal Spontaneous Delivery (NSD). legs Exams and Tests A pelvic examination may show signs similar to a normal pregnancy. 14-15 weeks AOG. ANATOMY AND PHYSIOLOGY The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. . PERSONAL DATA If your doctor suspects a molar pregnancy. a fast-growing cancerous form of gestational trophoblastic disease. and have complete immunizations when she was a child.Grape –sized vesicles . Gestational Trophoblastic Disease is proliferation and degeneration of the trophoblastic villi.No fetal heart sound are heard because there is no viable fetus. what are the causes and what are the signs and symptoms. no tenderness. hydatidiform moles may develop into invasive moles.

Other risk factors may include diets low protein.5 . Frequently there is no fetus at all.0.12 NOT DONEBASOPHILSNOT DONE0. nervousness heat intolerance unexplained weight loss. The cause os not completely understood .01 NOT DONESTABSNOT DONE0.fundusBody. vaginally. Sometimes. The abortionist runs the tip of the cannula along the surface of the uterus causing the baby to be dislodged and sucked into the tube . some of the villi from normally .3 layers EndometriumMyometriumPerimetrium Isthmus. symptoms of hyperthyroidism. and administration is often preceded by oral mifepristone. another pass is made through the mom's uterus with the suction machine to help insure that none of the baby's body parts have been left behind. often caused by anemia from heavy bleedingSudden severe abdominal pain caused by internal bleedingPelvic cramping or vaginal dischargeShortness of breath.. DIAGNOSIS A.0.folic acid and carotene. SIGNS AND SYMPTOMS Symptoms occur in conjunction with a potential. there is marked edema and enlargement of the villi with disappearance of the villous blood vessels..Assess for nausea and vomiting 4.Hydatidiform moles can exaggerate the usual symptoms of pregnancy. skin warmer and more moist than usual in about 10% of cases.05 NOT DONE V. The incomplete or partial mole is characterized by marked swelling of the villi and atrophic trophoblastic changes.On chromosomal analysis . The cause is not completely understood although potential causes. However.Assess for ability to work 5.g. and most women with molar pregnancies first believe they have miscarried. trembling hands. owing to their ability to induce uterine contractions and thus expel the products of conception. and/or nutritional deficiencies. RISK & PRE-DISPOSING FACTOR The condition tends to occur most often in women who have a low protein intake in young women (under age of 18 years). rapid heart rate. Amniotic fluid and the placenta are likewise suctioned through the tube and. The fetus. e.07 Increased due to parasitic infection MONOCYTESNOT DONE0.3 parts Internal osCervical canalExternal o IV.g. symptoms consistent with preeclampsia.Interstitial-1Isthmus-2 (tubal ligation)Ampulla-5 (site of fertilizationInfandibulum-2 Uterus Head. Surgical management Suction Curettage Abortion A common first trimester abortion procedure is the suction and curettage method. C.0 . e. The cannula is a hollow plastic tube that is connected to a vacuum-type pump by a flexible hose.) PLATELETS COUNT = Adequate HEMATOLOGYRESULTNORMAL VALUESINTERPRETATION HEMOGLOBIN86120 . With a complete mole. legs proteinuria. abnormalities within the uterus. Risk factors implicated include low socioeconomic status and diets low in protein.this chromosome component was contributed only by the father or an “empty ovum” was fertilized and the chromosome material was duplicated with a partial mole.874.24. In the complete or classic mole.01 .53 Decreased because immune system is affectedEOSINOPHILS0.0.A mole or choriocarcinoma also can cause the following symptoms:Abdominal swelling.g.6.0 x 1012 L Decrease O2 production due to Vaginal bleeding that cause anemiaWHITE BLOOD CELL11. especially between the 6th and 16th weeks of pregnancy. Although no embryo is present fetal blood may be present in the villi. which occurs more rapidly than expected for the first trimester of pregnancyExcessive vomiting during pregnancyFatigue.Provide written discharge and follow-up instructions 10. though this is not common. If an embryo forms.05 . a piece of tissue containing grapelike shapes will pass through the vagina.37 . cord and amniotic membrane are present and karyotype is abnornal. abdominal pain due to theca lutein cysts.0. Small amounts of bleeding can show up as a watery brown discharge from the vagina.A partial mole has 69 chromosomes (a triploid formation in which there are 3 chromosomes instead of 2 for every pair one set supplied by an ovum that apparently was fertilized by 2 sperm or an ovum fertilized by one sperm in which meiosis or reduction division did not occur). e.either whole or in pieces.The most common symptom is vaginal bleeding.. coughing or blood in coughed-up secretions because choriocarcinoma very rarely spreads to the lungs before it is diagnosedThere are many other causes for these symptoms. vaginal bleeding in pregnancy (first or second trimester).0. or rectally.isthmus Corpus.54 Decreased because the patient has Significant with hemorrhageRED BLOOD CELL2.22 . and carotene B. Any remaining parts are scraped out of the uterus with a surgical instrument called a curette. which primes the uterus by allowing local production of prostaglandins (normally suppressed by progesterone).Potential causes may include defects in the egg.Administer IV fluids as ordered 7. D.A macerate embryo of approximately 9 weeks gestation may be present.) COMPLETE BLOOD COUNT:2. Following that. DIAGNOSTIC AND LABORATORY LABORATORY EXAMINATION1.all trophoblastic villi swell and become cystic. end up in a collection jar.is swollen and misshaper. suspected.0 .750.150.080. severe enough to require hospitalization in 10% of cases.although the karyotype is normal 46xx or 46xy. encourage question and expression of feelings 8. karyotype is normal..0.0.Assess emotional distress 3. loose stools. Unlike the classic mole. or confirmed pregnancy. folic acid.corpusNeck.68 Increased because of WBC elevationLYMPHOCYTES0.250. together with the other body parts. MEDICAL/SURGICAL NURSING CARE MANAGEMENT Medical management Prostaglandins are the most commonly used agents. Prostaglandins can be given orally.002 .Provide and review information about any newly prescribed medications . these symptoms are associated with a normal pregnancy.this could also occur if one set of 23 chromosomes was supplied by one sperm and an ovum that did not undergo reduction division supplied 46. defects of the ovum (egg). or nutritional deficiencies. There is proliferation of the trophoblastic lining of the villi. Invasive moles and choriocarcinomas can cause symptoms during or after pregnancy.The syncytio-trophoblastic layer of villi. abnormal size in uterine growth for stage of pregnancy with 50% of cases with excessive in growth and approximately 1/3 of cases with smaller than expected. you should report any bleeding during pregnancy to your health care professional.g. triploidy or trisomy. that occur in the 1st or early in the 2nd trimester. Another symptom is bleeding that continues for a long time after delivery.38 . The contents of the collection jar are examined to assure that all fetal parts and an adequate amount of tissue commensurate with gestational age are present Nursing Care Management 1. high blood pressure swelling in feet.Misoprostol useful to help uterus expel products of conception that are not adherent to the uterine wall such as blood clots. It is important to remember that most vaginal bleeding during or after pregnancy is not associated with a molar pregnancy.Allow one support person at bedside following procedure if desired by patient 9. restlessness.Assess the ff: -v/s -amount and character of vaginal bleeding -uterine fundus 2. The incidence is increased in women under 20 or over 40 years old. DEFINITION Hydatidiform mole is a rare mass or growth which arise from fetal tissue that may form inside the uterus at the beginning of a pregnancy.10 x 109 L Slightly increased because infection started DIFFERENTIAL COUNT: NEUTROPHILS0.Report to health care provider -abnormal v/sBP <90HR >120RR <12 or >24 -acute abdominal pain -nausea and vomiting -excessive emotional distress -passing of large clots of blood / tissue 6. nausea and vomiting.it dies early at only 1 to 2mm in size with no fetal blood present in the villi. the fetus. so if you have such problems don't assume you have a molar pregnancy. e.Provide emotional support. Always speak with your health care professional. The abortionist begins by dilating the mom's cervix until it is large enough to allow a cannula to be inserted into her uterus. Many of the symptoms are similar to those associated with miscarriage.problems within the uterus. Usually.170 g/L Decrease protein production causing anemiaHEMATOCRIT0. caused by the uterus becoming larger. cord and amniotic membrane are absent.in women older than age of 35 years and in women of Asian heritage. have been suggested. ankles. and symptoms can develop after a hydatidiform mole has been removed. Women under 20 or over 40 years of age have a higher risk.however .

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