True about complete mole:a) Presence of foetal parts and cardiac activityb) Normal uterine sizec) Beta hCG doubling time is 7-10 daysd) Pre eclampsia at < 24 weekse) Per vaginal bleeding is commonest presentation
Complete Mole – Is that variety of H. mole in which no evidence of fetal tissue is seen. (i.e. option a is incorrect) M/C presenting symptom in H. mole is vaginal bleeding.
“Vaginal bleeding is the most-common symptom causing patient to seek treatment for complete mole pregnancy.” Novak 14/e, p 1585 (i.e. option ‘e’ is correct)
Early onset preeclampsia – if features of precampsia are present in < 24 weeks, complete mole should always be suspected (i.e. option ‘d’ is correct)
On P/A examination in molar pregnancy –size of the uterus in more than the expected period of amenorrhea in 70%,it corresponds with the period of amenorrhea in 20% and is smaller than the period of amenorrhea in 10% cases Thus normal size uterus may be seen in case of H. mole.
“Excessive uterine enlargement relative to gestational age is one of the classic signs signs of complete mole, although it is present in only about one half of the patients.
Novak 14/e, p 1585.
The clinical presentation of a complete mole has changed considerably over the past few decades.
“More than half of the patients diagnosed in the 1960’s and 1970’s had anemia and uterine size in excess of that predicted for gestational age. Complete moles, however, present infrequently today with these traditional signs and symptoms.”
Willimams Gynae 1/e, p757
So from above lines, it is clear that uterine size more than the period of amenorrhea, was earlier a more common and typical presentation of complete H. moles. These days more common picture is uterine size corresponding of the period of amenorrhea. Thus, I am including option ‘b’ in correct answers.
As far as hCG levels are concerned :
In case of molar pregnancy, levels of b-hCG are higher than that which are expected for that gestational age (due to trophoblastic proliferation), but the doubling time is same i.e. 1.4-2 days
bde
ade
ace
bce