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Molar and Ectopic Pregnancy

*Hydatidiform mole:

.Commoner in women of blood group A married to blood O men

.Group AB women have the worst prognosis

.Are commoner in older gravida

.Are complicated by ovarian cyst

.Can be diagnosed by U/S

.Uterine size is larger than dates

.Bilateral ovarian cysts (Lutein cysts) is common

.Aggravated morning sickness

.Treatment is by suction, curettage regardless of the size of the uterus

*The complications of hydatiform mole include all the following except:

.Hemorrhage

.Sepsis

.Perforation of the uterus

.Choriocarcinoma

*Ectopic pregnancy (etiological factors of ectopic pregnancy):

.It is a pregnancy that implants outside the uterus

.The most common site of implantation is the Ampulla

.It may occur in the cervix

.Previous infection is a major cause

.There is an increase incidence among IUCD users

.Shoulder pain is an important symptom

.Delayed passage of the fertilized ovum down the tube

.Progesterone pills for contraception

*The most important symptom of ectopic pregnancy is (pain)

*Vaginal bleeding in ectopic pregnancy is due to (Hormone withdrawal)

*Features suggest a diagnosis of ectopic pregnancy:

.Amenorrhea of 6-10 weeks

.Acute abdomen

.Decidual tissue at curettage

.Vaginal bleeding

.Endometrium has always secretory changes

.Fainting attacks

*Ectopic pregnancy is confirmed by (Laparoscopy)

*Chorionic villi at D&C pathology specimen can be a definite diagnosis of intrauterine pregnancy to rule out ectopic pregnancy

*Differential diagnoses of ectopic pregnancy:

.Acute salpingitis

.Acute appendicitis

.Acute red degeneration of fibroid

.Rupture (ovarian-corpus luteum) cyst

.Uterine abortion

.Torsion of fallopian tube

*A woman with a past history of three incidents of pelvic inflammatory disease is at greater risk for ectopic pregnancy

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