Chapter 093. Gynecologic Malignancies (Part 9)
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Clinical Presentation Molar pregnancies are generally associated with first-trimester bleeding and excessive uterine size. About 45% of patients have ovarian theca-lutein cysts present on ultrasound. The β-hCG levels are generally markedly elevated. Fetal parts and heart sounds are not present. The diagnosis is generally made by the passage of grapelike clusters from the uterus, but ultrasound demonstration of the hydropic mole can be diagnostic. Patients suspected of a molar pregnancy require a chest film, careful pelvic examinations, and weekly serial monitoring of β-hCG levels. Gestational Trophoblastic Neoplasia: Treatment Patients with hydatidiform moles require suction curettage coupled with postevacuation monitoring of β-hCG...
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