Pregnancy complete and partial is done by cgoss examination and histology
the high bhcg levels is resposnible for the clinical presentation of the molar pregnancy
complte mole maternal dna not present but with incomplete its as atleast present.
the p57kip2 staining is used by the patholist if they find it difficult to differienciate between the two. it stains the p57kip2gene which is maternally expressed and paternally silenced...so only posiitve with partial mole.
ultrasound can be used to detect a molar pregnacy early on itself!!!
beta hcg shows thyrotxociosis like featres becase shares a subunit with tsh
s and e instead of d and c because d and c will take a very long time to clear it out. the more time you mess around, the more chance of uterine bleeding.
baseline is serum beta hcg is important to evalaate the status aftr evacuation...must reduce.
no need to put the cannula compltely in... can jst put into the os and then rotate it while it sucks out.
hysterectomy can also be done if the patient is not willing for followup or can be lost to follow up bt most sri lankan patients will come for follow up.
but still even in hysterectomy there is risk of gtn
oxytocin can be used but only when theres bleeding or after the procedure as it increases chance of pulmonary embolism.
even gentle cureetage can be done after to make sure.
because risk f gtn after molar pregnancy which is not reduced by hysterectomy
the above numbered 3 are some of the dds of fundus more than dates
ABOVE CASE IS A common case that happens. missed abortion treatment but histo path report comes as molar pregnancy. so thats why shoulld always vcheck the histopath report of a missed pregnancy because mainly partial molar pregnancy is missed diagnosed as missed abortion.
serum hcg levels for early detection of gtn
theca luterin cysts because of lh like acticty of beta hcg
all the medical complications are much higher in a complete mole than a partial mole...partial mole its rare and thats why miss diagnosed as missed abortion
theca lutein by itself will just regress afterwards but in this case it has led to torsion which is a surgical emergency. no need to remove jst intwist\.
age increases the risk of most cancers
even in high risk, prophylactic chemo is not given
4 bhcg values are needed to detect plateaing of bhcg
and 3 for rising bhcg diagnosis
gtn is one cancer that can be diagnosed by blood tests alone!!!
first 2 of the below can be caused by invasive mole
drig of choice for chemotherapy is metho trexate