<prompt> In what of patients with hydatidiform mole height of uterus is more than expected for the period of amenorrrhea?10305070  <response>: Ans. d 70. Ref. Dutta, Obstetrics, 5th ed., 206HYDATIDIFORM MOLEVESICULAR MOLE Abnormal condition of ovum with partly degeneration partly hyperplastic changes in young chorionic villi. It is benign neoplasia of chorion with malignant potential. Highest incidence in Philippines Southeast Asia. In India 1 in 400. Can be complete or incomplete. Complete moles have 46XX karyotype, molar chromosomes derived entirely from father androgenous. Vesicle fluid is interstitial fluid rich in HCQ There is no trace of embryo or amniotic sac. Vaginal bleeding commonest presentation 90 Expulsion of grape-like vesicles per vaginum is diagnostic. Features of pre-eclampsia present in about 50. Size of uterus more than expected for period of ammenorrhea in 70, corresponds with period of ammenorrhea in 20 smaller in 10. Unilateral or bilateral enlargement of ovary Theca lutein Cyst in 25-50 of cases. USG - Snow storm appearance. HCG in urine between 1 in 200 to 1 in 500 beyond 100 days highly suggestive. There is 4-5 times higher risk of recurrence in future pregnancy. In-patient with mole in process of expulsion suction evacuation is best treatment. In patients with inert uterus, suction evacuation with oxytocin drip supplement is preferred treatment. Indications for hysterectomy:- Patient over 35 years of age.- Patient completed family irrespective of age Preferred time for curettage after vaginal evacuation 5-7days.FeaturePartial MoleComplete MoleKaryotypeUsually 69,XXX or 69,XXY46,XX or 46,XYPathologyEmbryo-fetusOften presentAbsentAmnion, fetal red blood cellsOften presentAbsentVillous edemaVariable, focalDiffuseTrophoblasticVariable, focal, slight to moderateVariable, slight to severeClinical presentationUterine sizeSmall for dates50 large for datesTheca-iutein cystsRare25-30Medical complicationsRareFrequentGestational trophoblastic neoplasia5-1020 