Investigations
1st investigations to order
histological examination of placental tissue
Test
Many women with hydatidiform mole terminate pregnancy before the development of the classic signs and symptoms.[35][48] For this reason, most authorities consider it mandatory to conduct histological examination of miscarriage tissue.[4][34]
Result
placental villi with irregular architecture, oedema with true villous cavitation, and trophoblast hyperplasia
serum human chorionic gonadotrophin (hCG)
Test
Abnormally elevated serum hCG levels for gestational age.
Result
often >100,000 IU/L (100,000 mIU/mL)
pelvic ultrasound
Test
May demonstrate snow-storm appearance of the uterine cavity and the absence of fetal parts (complete molar pregnancy); or a small placenta with partial fetal development (partial molar pregnancy).
Result
abnormal with uterine enlargement, may demonstrate ovarian cysts
Investigations to consider
FBC
Test
Anaemia may result from heavy or persistent vaginal bleeding and dilutional effects of increased blood volume.
Result
may show anaemia
serum PT, PTT
Test
A greater risk for serious bleeding at the time of evacuation for MP.
Result
may be prolonged
serum metabolic panel
Test
Normal liver and renal function may be essential for optimal dosing of chemotherapeutic agents.
Result
may show renal or hepatic dysfunction
serum thyroid-stimulating hormone (TSH)
Test
Cross-reactivity of beta hCG and TSH may lead to thyrotoxicosis in the absence of elevated levels of TSH.
Result
normal
blood type with antibody screen
Test
Blood typing ensures that type-appropriate blood can be made available in the event of haemorrhage.
Result
A, B, AB, O; Rhesus status may be negative or positive
CXR
Test
Pulmonary oedema may be secondary to high-output cardiac failure from severe pre-eclampsia and, less commonly, from anaemia or hyperthyroidism.
Alveolar infiltrates may be a sign of respiratory distress syndrome.
Pulmonary nodules may represent metastatic disease.
Result
may show Kerley B lines, fluid within pulmonary fissures, interstitial markings, alveolar infiltrates, pulmonary nodules
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