Molar pregnancy, or gestational trophoblastic disease, is a condition characterized by abnormal growth of trophoblastic tissue, typically following fertilization of an egg. To diagnose and manage a molar pregnancy, several investigations may be performed:
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Pelvic Ultrasound: This is the primary imaging technique used to evaluate a molar pregnancy. A transvaginal ultrasound can help visualize the lesions typical of a molar pregnancy, such as the "snowstorm" appearance of hydropic vesicles in complete moles or the presence of fetal tissue in partial moles.
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Human Chorionic Gonadotropin (hCG) Levels: Measurement of serum hCG levels is critical. In a molar pregnancy, hCG levels are often significantly elevated compared to normal pregnancy levels. Persistently high or rising levels after evacuation can indicate trophoblastic disease.
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Complete Blood Count (CBC): This test helps assess for anemia, which may occur due to excessive bleeding during a molar pregnancy.
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Liver and Kidney Function Tests: These tests evaluate organ function and rule out complications arising from the molar pregnancy.
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Pregnancy Test: A qualitative or quantitative urine or serum pregnancy test may be performed to confirm pregnancy, but serum hCG is more definitive for assessing molar pregnancies.
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Histopathological Examination: If a gestational tissue sample (usually obtained through dilation and curettage) is available, it can be examined microscopically to confirm the diagnosis of a complete or partial mole.
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Chest X-ray or CT Scan: In cases where there is a suspicion of metastatic disease (especially for gestational trophoblastic neoplasia), imaging may be done to evaluate for distant spread.
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Follow-Up hCG Monitoring: After treatment, regular follow-up of hCG levels is essential to ensure that levels return to normal and to monitor for the potential development of gestational trophoblastic neoplasia.
Each case may require a different approach based on clinical findings and the woman’s health status, but these investigations form the foundation of assessing and managing a molar pregnancy.