WHAT IS HYDATIDIFORM MOLE?

A hydatidiform mole occurs in apparently pregnant woman. It is a collection of vesicles - pearly white in color, translucent and containing watery fluid resembling bunches of grape. The vesicles may be from a few millimeter up to 2-3 cm diameter and are attached to the main stalk by thin pedicles. A few bleeding spots are seen in between the bunches. The fetus, amniotic sac and the placenta are conspicuously absent. Some hydatidiform moles erode the wall of the uterus, burrow into the myometrium and may even burst through the uterus.

WHY DOES IT OCCUR?

The disease usually occurs in young women below the age of 20 or in women of 40 and above. The incidence in higher among the lower socio-economic group. Dietary deficiency in protein, folic acid and iron and environmental factors are incriminated in the causation.

HOW DOES IT PRESENT?

The woman presents with pregnancy of less than 24 weeks gestation. She will give history of vaginal bleeding and abdominal pain. A woman may pass vesicles if she is aborting. The abdominal pain is either due to abortion, concealed bleeding, sudden distension of the uterus or rarely to perforation. Hyperemesis is reported in about 30% cases.

HOW IS IT REMOVED?

When a woman comes in the process of abortion, the vesicles can be identified amongst the products passed. Gentle exploration with finger or a gentle curettage will remove any remnants of mole. In some cases surgical management may be required.