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Query about hydatidiform mole - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Vaginal and Uterus Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   Hi
User :   Hello Doctor ...
Doctor :   How can I help you?
User :   I had few queries & clarifications regarding Molar Pregnancy .. could you pls help me ?
Doctor :   I shall guide you with your queries.
Doctor :   Please proceed with your query.
Doctor :   Are you there?
User :   yes yes ..
User :   my co-sister is suffering from Molar Pregnancy and was confirmed 2 months back ....
Doctor :   Ok
User :   she was treated for the same and was told for regular Beta HCG blood tests once in a week ..
Doctor :   Ok
User :   with the report observation she was told to get admitted again and doctors have gone for MRI Scan and then go for further treatment ..
Doctor :   Ok
User :   wanted to know is that the right track of the treatment for the disease ? and also what is the severity of the disease ? As I have read little bit about and also heard from the doctors that it is quite dangerous ..
Doctor :   Ok
Doctor :   Molar pregnancy is a benign condition which is locally malignant, meaning it can erode the uterus leading to complications.
User :   ok
Doctor :   Hence complete removal of the products is absolutely necessary.
Doctor :   If any products are left behind, then they need to be removed.
Doctor :   The means of knowing if any products are left behind, is be checking Beta HCG levels regularly.
User :   yes got it ..
Doctor :   So, if the HCG levels have not normalised, doctors may plan to reevaluate.
User :   right ... that is what is going now ... what is the purpose of MRI Scan ?
Doctor :   May I know which part is being scanned?
Doctor :   Do you mean MRI Pelvis?
User :   may be .. not sure ...
User :   what is the purpose but ?
Doctor :   Pelvis scan may be probably done to look for the products.
User :   ok ..
Doctor :   As I don't have access to her health records, and can't perform a physical examination, I would suggest that you speak to the gynaecologist who can answer you better
Doctor :   regarding the need for scan.
Doctor :   Are you there?
User :   yes ..
Doctor :   Have you followed what I have suggested?
Doctor :   Do you have any query?
User :   yes .. to detect the bad products in uterus is it not possible through ultra scam ?
Doctor :   Ultrasound scans can help, but MRI scans are more effective.
User :   ok.. one more query is if Molar Pregnancy is in its early stages what do u think is the bets treatment in general ?
Doctor :   I cannot pinpoint the purpose of an MRI without the access of her health records
Doctor :   The best form of treatment is by dilatation and curretage, but early stages can be treated by medical drugs.
Doctor :   Hence a trial of medical drugs can be done, if not effective, then dilatation and curretage is the best method of treatment.
Doctor :   Are you there?
User :   what exactly is done here "dilatation and curretage "
Doctor :   In D & C a short form, the uterus is dilated
Doctor :   and inner lining of the Uterus ( Endometriums) is scraped
Doctor :   and the scraping are sent for pathological analysis
User :   ok
Doctor :   In your case the molar pregnancy is scraped and sent
Doctor :   Did you follow?
User :   yes .... according to me the first treatment is already done 2 months back and the patient is kept under observation ... and now they are telling it is in-visible mode ... so they should be waiting for the visible mode and then need to proceed for further treatment ..
User :   am i right doctor ?
Doctor :   Right,
Doctor :   D&C helps both in confirming the diagnosis.
User :   ok ..
Doctor :   and if the molar pregnancy is diagnosed based on the histopathological analysis
User :   ok
Doctor :   then HCG Level monitoring is used to monitor the progress.
User :   ok
Doctor :   presence of products(that were not stripped off during the initial procedure) is indicated by presence of elevated HCG.
User :   ok
Doctor :   If that is the condition, then doctors may carry scans (an ultrasound or MRI pelvic scans) to visually locate the tumour and thereby aid in its removal.
Doctor :   In addition scans
User :   ok..
Doctor :   following a D&C may be done to see if there any uterine complications such as infection or adhesions.
User :   ok ...
Doctor :   Hence, without access to her records or physical examination, I cannot predict the reason for the scan.
Doctor :   Have you followed?
Doctor :   Do you have any other query?
User :   ok .. fine .. how long does this treatment takes ?
Doctor :   The treatment is in 2 stages.
Doctor :   1. D&C or alternatively medical drugs done after the diagnosis.
Doctor :   D&C as you might have found out, is done withing few minutes to an hour.
Doctor :   2. The second stage involves monitoring HCG levels for a period of 6 months to an year.
Doctor :   Ideally, the treating doctor looks for reducing levels of HCG.
Doctor :   A normal HCG Levels indicate successful and complete removal of the molar pregnancy, and thus successful treatment.
Doctor :   However occasionally few people may need repeat of the procedure to remove any additional products.
Doctor :   in such instances, the second step is again followed for certain period of time.
Doctor :   Hence depending on the levels of HCG, the duration of treatment varies.
Doctor :   Have you followed?
User :   yes .. now the second stage is in progress for the patient for whom i am referring and doctors have found that the HCG levels have not come back to normal a month after the first stage treatment ... so the patient is re-admitted now ..
Doctor :   Ok
User :   is the same treatment is given again now ? how long she should be in the hospital and how expensive is the treatment ?
Doctor :   Presence of remnants due to incomplete removal is treated by repeat D&C.
Doctor :   The need for this repeat D&C will be based on the present HCG Levels, the scan findings and pelvic examination.
Doctor :   From this far, without access to the findings of the reports, I cannot predict if a repeat of the procedure will be necessary.
User :   ok
Doctor :   Accordingly, the duration of stay (in the hospital) and the cost of treatment can be answered more appropriately only by her treating doctors.
Doctor :   Have you followed?
User :   yes .. if we think that patient is in early stages of Molar Pregnancy then how long it may take ?
Doctor :   Like I mentioned before, successful treatment can be achieved with complete removal of the molar pregnancy.
Doctor :   If the molar pregnancy has been removed successfully, HCG levels are expected to normalize in few months(2-3 months).
User :   ok..
Doctor :   And as I mentioned already, if certain products were left behind which is not uncommon, then HCG levels can persist to be high, in such instances repeat of the procedure will be needed.
Doctor :   Have you followed?
Doctor :   Thanks for consulting me. Bye for now.
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