Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD). When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.

1. By-
Sandhya Kumari
Nursing Tutor (OBG)
Metro College of Nursing, Greater Noida

2.  Hydatidiform mole is a rare mass or growth that forms
inside the uterus at the beginning of pregnancy. It is a
type of gestational trophoblastic disease (GTD).
 A cancerous form of GTD is called as
choriocarcinoma.
 The placenta feeds the fetus during pregnancy. With a
molar pregnancy, the tissues develop into an abnormal
growth called a mass.

3.  The estimated number is 1 of every 1,000 to 2,000
pregnancies.

4. There are two types:
 Partial (incomplete) molar pregnancy: There is an
abnormal growth of placenta and some fetal
development.
 Complete molar pregnancy: There is an abnormal
placenta but no fetus.

5.  Hydatidiform mole results from overproduction of the
tissue in that is supposed to develop into the placenta.
 Women older than 35 are at twice the risk and those
over age of 40 are 5-10 times more likely to develop H.
mole.
 Maternal age under 16 years are also at the risk.
 Problems during fertilisation
 Diet low in protein, vitamin A and animal fat

6.  Abnormal growth of uterus i.e. excessive growth in
>50% of cases and smaller than expected growth in
1/3rd of the cases.
 Nausea and vomiting severe enough to require a
hospital stay
 Vaginal bleeding during the first 3 months of pregnancy
 Passing of grape like vesicles through the vagina (first
3 months of pregnancy).

7.  Symptoms of hyperthyroidism i.e. heat intolerance,
loose stools, rapid heart rate, restlessness, nervousness,
skin warmer and more moist than usual, trembling
hands, unexplained weight loss
 Symptoms similar to pre-eclampsia i.e. elevated blood
pressure
 Fatigue
 Shortness of breath
 Coughing
 Abdominal swelling

8.  Unusally large uterus (50% cases) or too small (33%)
for gestation dates
 No fetal heart sound
 No quickening (fetal movement)

9.  Complete blood count
 Thyroid function
 Liver and kidney function test
 Level of human chorionic gonadotropin (hCG)
 Ultrasound of pelvis
 X-rays MRI or CT of chest, pelvis and brain to rule out
if the mole has metastasized outside the uterus

10.  Anaemia from chronic blood loss
 Toxemia of pregnancy
 Hyperthyroidism
 Heart failure
 Trophoblastic embolization leading to severe acute
respiratory problems (breathlessness).

11.  Rupture of the wall of uterus resulting in haemorrhage
 Development of choiocarcinoma
 Metastasis of cancer to lungs, lower genital tract, brain,
liver, kidney and gastro intestinal tract via blood stream
or lymphatic vessels.

12.  Some hydatidiform mole disappears spontaneously
 Dilatation and curettage
 Hysterectomy
 Abdominal hysterectomy (evacuation of mole through
incision made through abdomen into the uterus)

13.  Blood transfusion in cases with severe anaemia
 Chemotherapy and radiation for more aggressive moles
that have become malignant and for those women
whose hCG level does not return to normal levels after
evacuation.

14. The nurse should:
 Reassure the patient and give psychological support to
the patient.
 Provide good environment free from external stimuli to
ensure proper rest and sleep.
 Encourage to take the nutritious diet rich in protein,
vitamin A and animal fat.
 Administer the oxygen therapy to relieve
breathlessness.
 Provide sterile vaginal pads to prevent urinary tract
infection.

15.  Encourage to maintain personal hygiene and change the
clothes daily.
 Administer some analgesics as prescribed by the doctor
to relieve pain.
 Monitor the hCG level after molar pregnancy every
week initially. The hCG level generally drops to normal
within 8-12 weeks after evacuation of the mole. Once
the levels are consistently normal for 3-4 weeks,
monitoring is conducted monthly for 6 months.

16.  Advice the patient for effective contraception and not
to conceive during the period of follow up as the mole
can recur.
 Educate the mother for ultrasonography for future
pregnancies after getting treatment of the disease as
after 1st hydatidiform mole the risk for recurrence is 1.2
– 1.4% and after 2nd mole the risk increases to 20%.

17.  Prognosis for treated individual is excellent.
 Mortality is almost zero with early diagnosis and
treatment.
 After D & C 84% of complete and 99.5% of partial
hydatidiform moles get cured.
 After hysterectomy 3-5% become malignant and after
evacuation 15-20% of complete moles and 2-3% of
partial mole get malignant.

18.  D.C. Dutta. Textbook of Obstetrics.6th edition. New
Central Book Agency (P)LTD. 2004. 193-197.