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Questions and Answers
Which theory is NOT listed as a potential cause of Hydatidiform Mole (H-Mole)?
Which theory is NOT listed as a potential cause of Hydatidiform Mole (H-Mole)?
What is the main difference between a complete mole and a partial mole?
What is the main difference between a complete mole and a partial mole?
What is the typical number of chromosomes present in a partial mole?
What is the typical number of chromosomes present in a partial mole?
Which symptom is NOT commonly associated with Hydatidiform Mole?
Which symptom is NOT commonly associated with Hydatidiform Mole?
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What is one of the diagnostic tests used to identify Hydatidiform Mole?
What is one of the diagnostic tests used to identify Hydatidiform Mole?
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When can ultrasonography typically be performed to identify the grape-like vesicles associated with Hydatidiform Mole?
When can ultrasonography typically be performed to identify the grape-like vesicles associated with Hydatidiform Mole?
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What is the goal in managing a patient with gestational trophoblastic disease related to fluid volume deficit?
What is the goal in managing a patient with gestational trophoblastic disease related to fluid volume deficit?
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Why is monitoring hCG levels important in the management of gestational trophoblastic disease?
Why is monitoring hCG levels important in the management of gestational trophoblastic disease?
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What is the recommended postoperative nursing intervention for a patient with gestational trophoblastic disease?
What is the recommended postoperative nursing intervention for a patient with gestational trophoblastic disease?
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Why are oxytocin and prostaglandin contraindicated in patients with gestational trophoblastic disease?
Why are oxytocin and prostaglandin contraindicated in patients with gestational trophoblastic disease?
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What is the purpose of prophylactic chemotherapy in gestational trophoblastic disease management?
What is the purpose of prophylactic chemotherapy in gestational trophoblastic disease management?
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Which dietary recommendation is given to patients with gestational trophoblastic disease?
Which dietary recommendation is given to patients with gestational trophoblastic disease?
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Study Notes
Gestational Trophoblastic Disease (Hydatidiform Mole)
- Affects 1 out of 100 women, usually due to abnormal deterioration of embryo formation.
- Two types: complete mole and partial mole.
Complete Mole
- Characterized by swelling and cystic formation, with no fetal blood present.
- Associated with the development of choriocarcinoma.
- If an embryo develops, it will only last until 1-2 mm before dying.
Partial Mole
- Characterized by edema of some trophoblastic villi with some normal villi.
- Fetal blood may be present in the villi.
- Typically has 69 chromosomes, with 3 chromosomes for every 1 pair.
- The embryo will only last until 9 weeks gestation.
Causes of H-Mole
- Unknown, but unconfirmed theories include:
- Chromosomal abnormalities
- Hormonal imbalance
- Deficiency in protein and folic acid
- Increased hCG levels are present.
Signs and Symptoms
- Vaginal bleeding (brownish to bright red)
- Hyperemesis
- Lower abdominal cramps
- Uterus larger than expected for gestational age
- Grapelike vesicles in the vagina
- Ovarian enlargement due to cysts
- Absence of fetal heart rate tones
Lab Tests and Diagnosis
- Blood test: increased WBC and ESR
- Radioimmunoassay (RIA) shows elevated hCG
- Histologic examination
- Ultrasonography performed after 3rd month
- Amniography
- Doppler ultrasonography (shows absence of fetal heart rate)
Nursing Diagnosis
- Fluid volume deficit related to elevated hCG levels
- Nausea and vomiting, bleeding
- Goal: keep hydration (IV fluids and dry crackers)
Surgical Management
- Dilation and curettage
- Postoperative treatment: depending on blood loss and complications
- Monitoring of malignancy: weekly hCG levels until titers are negative for 3 consecutive weeks, then monthly for 6 months, then every 2 months for 6 months
- Chest X-rays to determine lung metastasis
Nursing Interventions
- Assess pt VS preoperatively
- Observe for signs of complications, such as hemorrhage and uterine infection
- Save any expelled tissue for laboratory analysis
- Prepare the pt for surgery
- Postoperatively: monitor VS, fluid intake and output, and check for signs of hemorrhage
- Encourage the pt and her family to assist with obtaining baseline information
- Instruct pt to report new symptoms promptly
- Explain the importance of using contraceptives, diet, and follow-up care to prevent hemorrhage and promote RBC maturation
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Description
Learn about the common causes of bleeding in the 2nd trimester, focusing on Gestational Trophoblastic Disease (Hydatidiform Mole). Understand the characteristics of complete and partial moles, their association with choriocarcinoma, and the risks involved.
