(^518) Medical-Surgical Nursing Demystified
cental site trophoblastic tumor. A complete mole is formed when an egg that has no
DNA is fertilized by a sperm. A partial mole has DNA from both parents and usu-
ally fetal parts. An invasive mole is a hydatidiform mole in the endometrium.
Choriocarcinomas are tumors composed of trophoblasts with bleeding. Placental
site trophoblastic tumors are trophoblasts which intrude the myometrium. All are
suggestive of malignancy and require a full metastatic work-up, including CT scan
of brain, kidneys, liver, and lung.
WHAT WENT WRONG?
There is thought to be a problem with the genetic material of the zygotes. The
chances are increased with an older mother, prior molar pregnancy, and a history
of miscarriage.
PROGNOSIS
Prognosis is the best for a woman diagnosed with a hydatidiform mole. Approx-
imately 20 percent of complete mole pregnancies result in further trophoblastic
disease. The remaining three diagnoses may point to malignancy. Most non-
metastatic malignancies have a good remission rate after treatment.
HALLMARK SIGNS AND SYMPTOMS
- Usual pregnancy signs during the first trimester
- Vaginal passing of a grapelike cluster of vesicles
- Vaginal bleeding
- Abnormally elevted hCG
- Abnormally large uterus
- Absence of fetal heart tones
- Elevated blood pressure
INTERPRETING TEST RESULTS
- Pelvic examination.
- hCG higher than expected serum levels in blood pregnancy test.
- Ultrasound.