Q: I am a student midwife in Chile. I study through a distance program and have close contact with the largest public hospital in the region. A friend on her fourth pregnancy was told it was a hydatidiform mole, and an immediate hysterectomy was ordered. I had never heard an immediate hysterectomy was necessary. Please tell me in detail the ifs ands and buts of this pregnancy complication.
-Aiyana Gregori
A D&C is usually performed as soon as possible after a diagnosis of a molar pregnancy. The mom is at risk of hemorrhage and other complications, of course, but the most worrisome is the connection with later cancer. As many as 4% will develop into choriocarcinoma. If the mole has invaded the uterus, or if the pregnancy is beyond 20 weeks, a hysterotomy or hysterectomy is usually needed.
-Gail Hart
Reprinted from Midwifery Today E-News (Vol 2 Issue 4, Jan 28, 2000)
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