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Knowing vesicular mole better



Posted
Dr. Ankur
Oct. 25, 2010

Vesicular mole or else known as hydatidiform mole are one of the prominent causes of bleeding in the early phase of pregnancy. Here the abnormal condition arises when the young developing fertilised ovum shows partly degeneration and partly hyper plastic changes in the chorionic villi (present over the ovum). These often result in cluster of cyst formations.

What leads to the mole?

  • Though the exact cause is difficult to coin but often it seems to arise with ovular defects as it sometimes affect one ovum of the twin pregnancy.
  • Age also plays a crucial role as it is more commonly seen in teenage pregnancies and in females over the age of 35 years.
  • Also the incidence may vary with race and origin. the highest incidence of the disorder is seen in Philippines with 1 in every 80 females  
  • Females with a positive personal or family history of vesicular mole increase the chances of developing the same.
  • Females with inadequate nutrition, inappropriate intake of high class proteins and low dietary carotene suggest increased risk.
  • Weak maternal immune system

Types of mole

These are broadly classified under complete and incomplete category where the complete mole forms with the death of the ovum. Here the cysts begin to appear in the 3rd to 5th week when the foetal maternal circulation has been established. These cysts are rich in HCG i.e. human chorionic gonadotropin hormone.

How the patient presents?

As mentioned above as well it is likely to be observed in teenagers and the elderly. The female gives a positive history of amenorrhea (absence of menstrual bleeding) of about 8 to 12 weeks with all initial suggestive features of pregnancy but have later on progressed in the following:

  • Vaginal bleeding: almost 90 % of the females suffering vesicular mole will present with vaginal bleeding often mistaken for abortion. This bleeding is preceded with brown or watery discharge. The blood may be mixed with fluid from the ruptures and the discharge may appear white particles in red fluid kinds.
  • Abdominal pain: this arises with the over distension of uterus, internal bleeding, infections and contractions that occur naturally to throw out the products of conception.
  • The patient will appear sick
  • Excessive vomiting: with excess of HCG circulating within the body the vomiting rises severely in degree. So much so requiring hospitalisation to curtail.
  • The diagnostic feature is the grape like expulsion of vesicles per vaginum.

Detection

With the signs, symptoms and discharges the condition is very much detectable but laboratory investigations are essential to ensure complete clean up and no residual effects.

Blood evaluation, ultrasound, high urine HCG, X ray abdomen all indicate towards the situation and also help a doctor to plan out the entire execution in the right way.

How to manage?

Here an expert gynaecologist can help relieve of the physical pain but the mental pain needs to be pampered. As a mother who experiences life for 8 to 12 weeks can only understand her loss. Support her and make effort to recover the blood loss with measures to strike off any infections what so ever.

        

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