STUDY OF MOLAR PREGNANCY IN A TERTIARY CARE CENTER- A CASE SERIES
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Abstract
Abstract
Background: Rate of molar pregnancy is higher in extremes of age. There is 1% & >10% incidence of molar pregnancy if previous history of 1&2 molar pregnancies respectively. Most patients present with heavy vaginal bleeding in first trimester. The role of clinical suspicion, early diagnosis, varied presentations, appropriate management and prompt follow up is being studied. .
Methods: The study is Retrospective-Observational study carried out in RL Jalappa Hospital (RLJH) ,Kolar from January2022-December2023 after taking inclusion criteria (a)Patients aged >18 years. b)Molar pregnancy confirmed by ultrasound)into consideration and risk factors, clinical outcome, management, complications and beta-hCG level follow-up were reviewed and outcomes obtained.
Results: 8 cases of molar pregnancy identified from Jan2022-Dec2023.1patient failed to follow up. 3patients diagnosed as partial-molar pregnancy and 5 cases as complete-molar pregnancy. 1 case of complete mole who underwent suction-evacuation was non-compliant for follow-up; she presented 1½months later with Choriocarcinoma with lung metastasis and treated with 4 cycles of chemotherapy.
Conclusions: Hydatidiform-mole is an obstetrical emergency affecting 1/500-1000 pregnancies. Extremes of age, history of molar pregnancy contribute as risk factors. Increased number of blood transfusions were noted. Suction-evacuation is choice of management irrespective of uterine size. Hysterectomy is done if family is complete. Strict serial beta-hCG monitoring facilitates early diagnosis and management. Proper counselling, patient compliance is key in achieving complete cure. Pregnancy can be planned once beta-hCG levels have been undetecable for 6 months.