molar pregnancy

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Specializes in Behavioral Health.

I have a patient that has been diagnosed with a molar pregnancy,and this client has the appearance of a third trimester pregnancy. Is it typical for someone to go this long without intervention? :eek:

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More than likely, she has not been pregnant for that long. One of the signs of a molar pregnancy is very rapid uterine growth.

I looked up some information one time on molar pregnancies and was horrified. That poor patient. :(

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Uterine size for dates discrepancy is common with hydatidiform molar pregnancies. The vesicles are highly prolific and grow MUCH faster than a fetus. Also it is common for the ovaries to become cystic and enlarged, as well, giving a larger appearance. Likely, the woman has not reached the third trimester. Many women with molar pgs experience lady partsl bleeding or spotting or excessive N&V that drive them to seek care. It is possible that initially she may not have known she was pg and thought the bleeding was of a menstrual nature, I suppose, but it is somewhat unusual that if she was getting routine prenatal care that she would have gotten very far along with today's routine use of ultrasound, bHCG and doppler. Likely there would have been an absence of fetal heart tones, as frequently there is no fetus.

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Specializes in Behavioral Health.
:cry: Yes, indeed. This is a very sad case. I work on Behavioral Health in the local hospital, and I love my clients. This client is Schizoaffective and is not fully aware of what is going on . I am going to attempt to observe during her surgery, and be present when she is in recovery to decrease her fear. She has no one to support her, which is not uncommon with the mentally ill. Ya'll send up a prayer for her on Thursday. Thanks for all the great info on this issue. Also, in reference to the prenatal care, she is homeless and did not even visit a physician , ED dept. until she became syptomatic. She is not even aware of her sexual encounter, so she doesn't understand why she is sick and in pain.
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So sad, April. I attended a young woman once at the county hospital (as a support person) when her family DUMPED her off in labor, alone. No prenatal care, but clearly pg. She was early 20s, but functioned at about a 4-5 year old level. She didn't know what was going on, why her belly hurt, she claimed that she didn't know she was having a baby, but would sometimes say things like, "I can't keep the baby. Do you want it?" She wasn't sure how she got pregnant. She responded beautifully to her labor, she was so in the moment, she didn't need any pain meds. She was so sweet and trusting. It was an amazing experience for me, as well, but broke my heart. She ended up with a c/sec because she was developing an infection - her water had been broken who knows how long. CPS and social services got involved and I don't know what ever happened to her or her baby. It was really hard when she offered the baby to me because I was "nice." :(

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Oh, I also meant to say that it is wonderful that you can serve as a support for that young woman. I am sure that it will help her tremendously.

Take care

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My best friend had a molar pregnancy. She was very, very sick all the time. She threw up at least, AT LEAST 10 times a day. She would tell her DR. and she told her that it was normal. They didn't find out what was going on with her until she was 4 months pregnant. She went in for an ultrasound and the tech made the comment, "you must be about 3 months along", she knew then something was very wrong.

They had her admitted that day and aborted the baby. After that, her lungs collapsed and she developed cervical cancer. I have no idea if one had anything to do with the other. Her lungs collapsed within a week of the whole ordeal. Cervical cancer about 3 months later. She was 21.

It was very tramatic for her.

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we just learned about this in OB and PEDS.....was a test question too......

there is no acutual fetus if i am not mistaken.....just a bunch of grapelike vesicles....our intsructors daughter in law just went thru this a few months ago.....she never told us about it til we came upon this subject a few days ago.....

it is so cool coming here and actually knowing what is being talked about.....so sad for the young woman though......i am very sorry....she is lucky to have such a caring nurse.....

paula....soon to gradutate in 26 days...:nurse:

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