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HYDATIDIFORM MOLE
Hyatidiform Mole
Developmental anomaly of the placenta resulting in the conversion of the chorionic villi into a mass of clear vesicles
Hyatidiform Mole
Hyatidiform Mole
As the cells degenerate, they become filled with fluid and appear as clearfilled, grape-sized vesicles.
Hyatidiform Mole
Types of H-mole
COMPLETE H-MOLE
Develop from anuclear ovum that contains no maternal genetic material, an (empty egg)
23
DUPLICATION
46
46XX or 46XY
BACK
PARTIAL H-MOLE
23
69
69XXY or 69XYY
23 23 23 69
BACK
A macerated embryo of approximately 9 wks may be present with fetal blood in the villi
Predisposing Factors
Low protein Woman older than 35 yrs old Women of Asian Heritage
ASSESSMENT FINDINGS: signs and symptoms
DIAGNOSTIC TEST .
ASSESSMENT FINDINGS
Vaginal bleeding (16th wk): brownish like prune juice Uterine enlargement NO fetal heart sounds NO fetal skeleton (ultrasound) Elevated serum level hCG (1M-2M IU (Normal: 400,000 IU) Hyperemesis gravidarum PIH Hyperthyroidism thyrotoxicosis
COMPLICATION
BACK
P-ulmonary embolus A-nemia T-rophoblastic embolization of the lungs seen after molar evacuation of enlarged uterus C-horiocarcinoma H-yperthyroidism, H-emorrhage E-mbedded infection D-isseminated Intravascular Coagulation (DIC)
DIAGNOSTIC TEST
MEDICAL MANAGEMENT
Suction Curettage D&C Dilatation and Curettage Hysterectomy Anti- metabolite Drugs (Methotrexate, Dactinomycin) Blood Transfusion
NURSING INTERVENTIONS
Provide pre/postoperative care for evaluation of uterus Prepare pt. for surgery Teach contraceptive use Follow up lab work Monitoring 3 mos and periodic follow up for 6-12 mos Pelvic examinations and chest X-ray Teach about risk for future pregnancies
NURSING INTERVENTIONS
Assess pt. V/S for basline Monitor signs of hemorrhage Provide emotional support for loss of pregnancy Help pt. and family develop effective coping strategies